{
"Npi": {
"NPI": "1831379163",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KEITH A. MALLATT OD",
"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": "301 N BROADWAY ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PITTSBURG",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "66762-4806",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "620-231-1720",
"MailingAddressFaxNumber": "620-231-1727",
"FirstLinePracticeLocationAddress": "301 N BROADWAY ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PITTSBURG",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "66762-4806",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "620-231-1720",
"PracticeLocationAddressFaxNumber": "620-231-1727",
"EnumerationDate": "11/03/2007",
"LastUpdateDate": "04/20/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MALLATT",
"AuthorizedOfficialFirstName": "KEITH",
"AuthorizedOfficialMiddleName": "ALLEN",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "620-231-1720",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332H00000X",
"TaxonomyName": "Eyewear Supplier",
"LicenseNumber": "KS 1173-2",
"LicenseNumberStateCode": "KS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}