{
"Npi": {
"NPI": "1730351248",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PAMELA KELLY PULLEN",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1830 14TH AVE S",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BIRMINGHAM",
"MailingAddressStateName": "AL",
"MailingAddressPostalCode": "35205-4969",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "205-933-8436",
"MailingAddressFaxNumber": "205-933-2221",
"FirstLinePracticeLocationAddress": "1830 14TH AVE S",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BIRMINGHAM",
"PracticeLocationAddressStateName": "AL",
"PracticeLocationAddressPostalCode": "35205-4969",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "205-933-8436",
"PracticeLocationAddressFaxNumber": "205-933-2221",
"EnumerationDate": "03/25/2008",
"LastUpdateDate": "12/06/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PULLEN",
"AuthorizedOfficialFirstName": "PAMELA",
"AuthorizedOfficialMiddleName": "KELLY",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OPTICIAN",
"AuthorizedOfficialTelephoneNumber": "205-933-8436",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "06012756",
"LicenseNumberStateCode": "AL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}