{
  "npi": "1083088058",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "FNP-C",
    "authorized_official_first_name": "MICHAEL",
    "authorized_official_last_name": "HOLTZ",
    "authorized_official_middle_name": "PAUL",
    "authorized_official_telephone_number": "6602684006",
    "authorized_official_title_or_position": "Owner/CEO/Provider",
    "enumeration_date": "2015-11-13",
    "last_updated": "2018-05-03",
    "organization_name": "ADVANCED MEDICAL HOUSE CALL AND TELEMEDICINE, L.L.C.",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "624 W LOCKLING ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "BROOKFIELD",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "660-258-9006",
      "postal_code": "646282003",
      "state": "MO",
      "telephone_number": "660-268-4006"
    },
    {
      "address_1": "PO BOX 224",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "BROOKFIELD",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "660-530-9992",
      "postal_code": "646280224",
      "state": "MO",
      "telephone_number": "660-530-9992"
    }
  ],
  "taxonomies": [
    {
      "code": "261QP2300X",
      "desc": "Clinic/Center, Primary Care",
      "license": "2014033136",
      "primary": false,
      "state": "MO",
      "taxonomy_group": ""
    },
    {
      "code": "363LF0000X",
      "desc": "Nurse Practitioner, Family",
      "license": "2014033136",
      "primary": true,
      "state": "MO",
      "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": "Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "50",
        "medicare_type": "Nurse Practitioner"
      }
    ]
  }
}