{
  "npi": "1043814288",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "Ph.D.",
    "authorized_official_first_name": "ANDREW",
    "authorized_official_last_name": "POTTER",
    "authorized_official_telephone_number": "6178161818",
    "authorized_official_title_or_position": "Psychologist",
    "certification_date": "2020-11-29",
    "enumeration_date": "2020-11-29",
    "last_updated": "2020-11-29",
    "organization_name": "ANDREW POTTER, PH.D., PSYCHOLOGIST, INC.",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "2320 SARITA CT",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "PINOLE",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "945641527",
      "state": "CA",
      "telephone_number": "617-816-1818"
    },
    {
      "address_1": "1460 MARIA LN STE 300",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "WALNUT CREEK",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "945965314",
      "state": "CA",
      "telephone_number": "617-816-1818"
    }
  ],
  "taxonomies": [
    {
      "code": "103TB0200X",
      "desc": "Psychologist, Cognitive & Behavioral",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "103TC1900X",
      "desc": "Psychologist, Counseling",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "103TC2200X",
      "desc": "Psychologist, Clinical Child & Adolescent",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "103TF0000X",
      "desc": "Psychologist, Family",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "103TS0200X",
      "desc": "Psychologist, School",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "103T00000X",
      "desc": "Psychologist",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": "193200000X - Multi-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": "Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "62",
        "medicare_type": "Psychologist, Clinical"
      }
    ]
  }
}