{
"Npi": {
"NPI": "1891332383",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "D.J. MILLER O.D. AND ASSOCIATES, LLC",
"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": "1000 JOHNNIE DODDS BLVD STE 103-190",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MOUNT PLEASANT",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29464-3135",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "828-208-2215",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1057 BROAD ST STE 48",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SUMTER",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29150-2565",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "828-208-2215",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/04/2019",
"LastUpdateDate": "01/24/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MILLER",
"AuthorizedOfficialFirstName": "DANIEL",
"AuthorizedOfficialMiddleName": "JUSTIN",
"AuthorizedOfficialTitle": "OPTOMETRIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OD",
"AuthorizedOfficialTelephoneNumber": "828-208-2215",
"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."
}
}
}
}