{
  "npi": "1003202847",
  "enumeration_type": "NPI-1",
  "basic": {
    "certification_date": "2021-06-16",
    "credential": "D.O.",
    "enumeration_date": "2015-04-08",
    "first_name": "SHAN",
    "last_name": "FAIRBANKS",
    "last_updated": "2021-06-16",
    "middle_name": "R",
    "sex": "M",
    "sole_proprietor": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "118 BROAD ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "DUBLIN",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "540-674-8670",
      "postal_code": "240843211",
      "state": "VA",
      "telephone_number": "540-674-8805"
    },
    {
      "address_1": "213 S JEFFERSON ST STE 625",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "ROANOKE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "540-224-5684",
      "postal_code": "240111713",
      "state": "VA",
      "telephone_number": "540-224-5516"
    }
  ],
  "taxonomies": [
    {
      "code": "207Q00000X",
      "desc": "Family Medicine",
      "license": "0102204926",
      "primary": true,
      "state": "VA",
      "taxonomy_group": ""
    },
    {
      "code": "207QS0010X",
      "desc": "Family Medicine, Sports Medicine",
      "license": "0102204926",
      "primary": false,
      "state": "VA",
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)",
    "certifying_board": "American Board of Family Medicine (ABFM)",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "08",
        "medicare_type": "Physician/Family Practice"
      }
    ]
  }
}