{
"Npi": {
"NPI": "1982835021",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SUTARIA EYE CARE, PLLC",
"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": "3600 S GLEBE RD",
"SecondLineMailingAddress": "227",
"MailingAddressCityName": "ARLINGTON",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22202-2365",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "703-203-9656",
"MailingAddressFaxNumber": "703-203-9656",
"FirstLinePracticeLocationAddress": "42395 RYAN RD",
"SecondLinePracticeLocationAddress": "SUITE 120",
"PracticeLocationAddressCityName": "ASHBURN",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "20148-4863",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "703-203-9656",
"PracticeLocationAddressFaxNumber": "703-203-9656",
"EnumerationDate": "08/06/2009",
"LastUpdateDate": "08/06/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SUTARIA",
"AuthorizedOfficialFirstName": "MEERA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT/OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "703-203-9656",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "0618001658",
"LicenseNumberStateCode": "VA",
"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."
}
}
}
}