{
"Npi": {
"NPI": "1912111725",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PATABI RAJ SEETHARAMAN",
"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": "32280 WINTERGREEN DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SOLON",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44139-1356",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "440-248-2542",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "251 PORTLAND WAY N",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GALION",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44833-1632",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "419-468-5200",
"PracticeLocationAddressFaxNumber": "419-468-3719",
"EnumerationDate": "05/10/2007",
"LastUpdateDate": "04/19/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SEETHARAMAN",
"AuthorizedOfficialFirstName": "PATABI",
"AuthorizedOfficialMiddleName": "RAJ",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "419-468-5200",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "4617T1363",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207W00000X",
"TaxonomyName": "Ophthalmology Physician",
"LicenseNumber": "35057803",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}