{
  "npi": "1023558905",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "LESLIE",
    "authorized_official_last_name": "JACKSON",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "8439929132",
    "authorized_official_title_or_position": "RN",
    "enumeration_date": "2017-02-27",
    "last_updated": "2017-02-27",
    "organization_name": "DHEC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "319 STEPHEN CT",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "MULLINS",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "295744223",
      "state": "SC"
    },
    {
      "address_1": "319 STEPHEN CT",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "MULLINS",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "295744223",
      "state": "SC",
      "telephone_number": "843-992-9132"
    }
  ],
  "taxonomies": [
    {
      "code": "313M00000X",
      "desc": "Nursing Facility/Intermediate Care Facility",
      "license": "235692",
      "primary": true,
      "state": "SC",
      "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": "Licensed & Credentialed Nursing and Custodial Care Facilities — Nursing Facility",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "A3[10]",
        "medicare_type": "Other Nursing Facility"
      }
    ]
  }
}