{
  "npi": "1104296607",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "OCTAVIA",
    "authorized_official_last_name": "WILLIAMS",
    "authorized_official_middle_name": "JACKSON",
    "authorized_official_telephone_number": "3185610946",
    "authorized_official_title_or_position": "Credentialing Specialist",
    "certification_date": "2022-01-19",
    "enumeration_date": "2015-09-28",
    "last_updated": "2022-01-19",
    "organization_name": "ALEXANDRIA EYE AND LASER CENTER, LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "65 MEDICAL PARK BLVD",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "PINEVILLE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "318-441-9976",
      "postal_code": "713608428",
      "state": "LA",
      "telephone_number": "318-641-2400"
    },
    {
      "address_1": "231 WINDERMERE BLVD",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "ALEXANDRIA",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "318-427-0181",
      "postal_code": "713033538",
      "state": "LA",
      "telephone_number": "318-487-2020"
    }
  ],
  "taxonomies": [
    {
      "code": "332H00000X",
      "desc": "Eyewear Supplier (Equipment, not the service)",
      "license": null,
      "primary": true,
      "state": "LA",
      "taxonomy_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 Eyewear Supplier (Equipment, not the service)",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": []
  }
}