{
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    "last_updated": "2025-12-05",
    "middle_name": "J.",
    "sex": "M",
    "sole_proprietor": "NO",
    "status": "A"
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    {
      "address_1": "PO BOX 60538",
      "address_purpose": "MAILING",
      "address_type": "DOM",
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      "country_code": "US",
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    },
    {
      "address_1": "1600 SW ARCHER RD",
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      "city": "GAINESVILLE",
      "country_code": "US",
      "country_name": "United States",
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      "state": "MA",
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      "code": "363LP0808X",
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      "status": "CLEAR",
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    "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 Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
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        "medicare_code": "50",
        "medicare_type": "Nurse Practitioner"
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}