{"result_count":1,"results":[{"addresses":[{"address_1":"104 12TH AVE NW","address_2":"SUITE #1","address_purpose":"MAILING","address_type":"DOM","city":"HAZEN","country_code":"US","country_name":"United States","fax_number":"701-748-5221","postal_code":"585454100","state":"ND","telephone_number":"701-748-5220"},{"address_1":"104 12TH AVE NW","address_2":"SUITE #1","address_purpose":"LOCATION","address_type":"DOM","city":"HAZEN","country_code":"US","country_name":"United States","fax_number":"701-748-5221","postal_code":"585454100","state":"ND","telephone_number":"701-748-5220"}],"basic":{"authorized_official_credential":"O.D.","authorized_official_first_name":"DEREK","authorized_official_last_name":"CZYWCZYNSKI","authorized_official_middle_name":"DAVID","authorized_official_name_prefix":"Dr.","authorized_official_name_suffix":"--","authorized_official_telephone_number":"7015162115","authorized_official_title_or_position":"Owner/Optometrist","enumeration_date":"2014-04-18","last_updated":"2023-03-07","organization_name":"HAZEN FAMILY EYECARE PC","organizational_subpart":"NO","status":"A"},"created_epoch":"1397847230000","endpoints":[],"enumeration_type":"NPI-2","identifiers":[{"code":"01","desc":"Other (non-Medicare)","identifier":"1427281583","issuer":"Optometrist NPI","state":"ND"},{"code":"05","desc":"MEDICAID","identifier":"60698","issuer":null,"state":"ND"},{"code":"01","desc":"Other (non-Medicare)","identifier":"12122586","issuer":"CAQH","state":"ND"},{"code":"01","desc":"Other (non-Medicare)","identifier":"681","issuer":"State License Number","state":"ND"}],"last_updated_epoch":"1678238276000","number":"1306266291","other_names":[],"practiceLocations":[],"taxonomies":[{"code":"152W00000X","desc":"Optometrist","license":"681","primary":true,"state":"ND","taxonomy_group":"193400000X - Single Specialty Group"}]}]}