{
"Npi": {
"NPI": "1730611039",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ASHLEY VISION CENTER, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "13131 PLANK RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BAKER",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70714-4914",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "225-775-9406",
"MailingAddressFaxNumber": "225-775-0258",
"FirstLinePracticeLocationAddress": "13131 PLANK RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BAKER",
"PracticeLocationAddressStateName": "LA",
"PracticeLocationAddressPostalCode": "70714-4914",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "225-775-9406",
"PracticeLocationAddressFaxNumber": "225-775-0258",
"EnumerationDate": "03/28/2017",
"LastUpdateDate": "03/28/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WATERS",
"AuthorizedOfficialFirstName": "ASHLEY",
"AuthorizedOfficialMiddleName": "MONIQUE",
"AuthorizedOfficialTitle": "CO-OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "225-775-9406",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "1014",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}