{"npi":"1164058798","type":"NPI-2","status":"active","name":{"display":"Kenneth Boyer OD, INC","other":[],"organization_name":"KENNETH BOYER OD, INC","authorised_official":"Patricia Daniels"},"specialty":{"primary_taxonomy":"152W00000X","primary_taxonomy_description":"Optometrist","slug":"optometrist","schema_org_specialty":null,"all":[{"code":"152W00000X","description":"Optometrist","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"2443 FOOTHILL BLVD","city":"LA VERNE","state":"CA","postal_code":"917503028","country_code":"US","phone":"9095966756","fax":"9095930786"},{"purpose":"MAILING","street_1":"2443 FOOTHILL BLVD","city":"LA VERNE","state":"CA","postal_code":"917503028","country_code":"US","phone":"9095966756","fax":"9095930786"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"GSD000651","state":"CA","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2020-03-16","last_updated":"2023-11-27","_meta":{"source":"NPPES","snapshot_date":"2023-11-27","doc_url":"https://findmynpi.com/api"}}