{
  "npi": "1073947305",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "M.D.",
    "authorized_official_first_name": "JONATHAN",
    "authorized_official_last_name": "DAVIDSON",
    "authorized_official_middle_name": "SAM",
    "authorized_official_name_prefix": "Dr.",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "2097517165",
    "authorized_official_title_or_position": "CEO",
    "enumeration_date": "2013-08-22",
    "last_updated": "2013-08-22",
    "organization_name": "ADVANCED SLEEP AND GASTROENTEROLOGY LABORATORIES, INC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "PO BOX 3068",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "CERES",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "209-579-2354",
      "postal_code": "953079032",
      "state": "CA",
      "telephone_number": "209-751-7165"
    },
    {
      "address_1": "4206 TECHNOLOGY DR",
      "address_2": "SUITE 2",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "MODESTO",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "209-579-2354",
      "postal_code": "953568769",
      "state": "CA",
      "telephone_number": "209-492-0735"
    }
  ],
  "taxonomies": [
    {
      "code": "207RS0012X",
      "desc": "Internal Medicine, Sleep Medicine",
      "license": "G66389",
      "primary": false,
      "state": "CA",
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "207RG0100X",
      "desc": "Internal Medicine, Gastroenterology",
      "license": "G66389",
      "primary": true,
      "state": "CA",
      "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": "Board-Certified Gastroenterologist (Digestive Tract & Liver Specialist)",
    "certifying_board": "American Board of Internal Medicine — Gastroenterology",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "10",
        "medicare_type": "Physician/Gastroenterology"
      },
      {
        "medicare_code": "11",
        "medicare_type": "Physician/Internal Medicine"
      }
    ]
  }
}