{
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"OrgName": "VIVID EYES OPTOMETRY PLLC",
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"FirstLineMailingAddress": "569 SUMMITT DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JOHNSON CITY",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37604-2753",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1001 OVER MOUNTAIN DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ELIZABETHTON",
"PracticeLocationAddressStateName": "TN",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "423-268-1474",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/02/2022",
"LastUpdateDate": "07/06/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STONECYPHER",
"AuthorizedOfficialFirstName": "LINNEA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OPTOMETRIST/OWNER",
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"AuthorizedOfficialCredential": "OD",
"AuthorizedOfficialTelephoneNumber": "251-533-7168",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}