{
"Npi": {
"NPI": "1881840221",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "IMAGE OPTICAL, INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4121 OECHSLI AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LOUISVILLE",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "40207-5022",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "502-895-8135",
"MailingAddressFaxNumber": "502-895-8133",
"FirstLinePracticeLocationAddress": "4121 OECHSLI AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LOUISVILLE",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "40207-5022",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "502-895-8135",
"PracticeLocationAddressFaxNumber": "502-895-8133",
"EnumerationDate": "08/18/2008",
"LastUpdateDate": "08/18/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PAULINE",
"AuthorizedOfficialFirstName": "JON",
"AuthorizedOfficialMiddleName": "RICHARD",
"AuthorizedOfficialTitle": "PRESIDENT/OPTICIAN",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LICENSED OPTICIAN",
"AuthorizedOfficialTelephoneNumber": "502-895-8135",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "388",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}