{
  "npi": "1093913543",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "MD",
    "authorized_official_first_name": "THOMAS",
    "authorized_official_last_name": "CEBALLOS",
    "authorized_official_name_prefix": "Dr.",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "8102309215",
    "authorized_official_title_or_position": "PRESIDENT",
    "enumeration_date": "2007-07-06",
    "last_updated": "2015-01-11",
    "organization_name": "ASSOCIATED RADIOLOGISTS OF INVERNESS PA",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "4300 N ACCESS RD",
      "address_2": "SUITE D",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "CHATTANOOGA",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "423-826-1290",
      "postal_code": "374153812",
      "state": "TN",
      "telephone_number": "423-826-1276"
    },
    {
      "address_1": "502 W HIGHLAND BLVD",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "INVERNESS",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "344524720",
      "state": "FL",
      "telephone_number": "352-344-6481"
    }
  ],
  "taxonomies": [
    {
      "code": "2085R0202X",
      "desc": "Radiology, Diagnostic Radiology",
      "license": null,
      "primary": true,
      "state": null,
      "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": "Board-Certified Diagnostic Radiologist (MRI, CT, Ultrasound & X-Ray Specialist)",
    "certifying_board": "American Board of Radiology (ABR) / FRCR",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "30",
        "medicare_type": "Physician/Diagnostic Radiology"
      }
    ]
  }
}