{"npi":"1104010594","type":"NPI-2","status":"active","name":{"display":"Roswell Eye Clinic, INC","other":[],"organization_name":"ROSWELL EYE CLINIC,INC","authorised_official":"Sharon Moscow"},"specialty":{"primary_taxonomy":"152W00000X","primary_taxonomy_description":"Optometrist","slug":"optometrist","schema_org_specialty":null,"all":[{"code":"152W00000X","description":"Optometrist","primary":true,"state":"GA","license":"861-T"}]},"addresses":[{"purpose":"LOCATION","street_1":"1190 GRIMES BRIDGE RD","city":"ROSWELL","state":"GA","postal_code":"300753930","country_code":"US","phone":"7709927620","fax":"7709928262"},{"purpose":"MAILING","street_1":"1190 GRIMES BRIDGE RD","city":"ROSWELL","state":"GA","postal_code":"300753930","country_code":"US","phone":"7709927620","fax":"7709928262"}],"license":{"state":"GA","number":"861-T"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"00168583A","state":"GA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20110315000050","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"GA","pac_id":"7214119114"}]},"enumeration_date":"2007-08-29","last_updated":"2011-02-28","_meta":{"source":"NPPES","snapshot_date":"2011-02-28","doc_url":"https://findmynpi.com/api"}}