{
  "npi": "1013069624",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "CAROL",
    "authorized_official_last_name": "HIPKE",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "7157322078",
    "authorized_official_title_or_position": "Director of Business Services",
    "enumeration_date": "2007-01-17",
    "last_updated": "2017-03-14",
    "organization_name": "NORTHREACH HEALTHCARE, LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "PO BOX 22487",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "GREEN BAY",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "920-445-7229",
      "postal_code": "543052487",
      "state": "WI",
      "telephone_number": "920-445-7226"
    },
    {
      "address_1": "218 S HWY 141",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "CRIVITZ",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "715-854-7785",
      "postal_code": "541141677",
      "state": "WI",
      "telephone_number": "715-854-7477"
    }
  ],
  "taxonomies": [
    {
      "code": "291U00000X",
      "desc": "Clinical Medical Laboratory",
      "license": "52D0394395",
      "primary": false,
      "state": "WI",
      "taxonomy_group": ""
    },
    {
      "code": "207Q00000X",
      "desc": "Family Medicine",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": "193400000X - Single Specialty 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"
      }
    ]
  }
}