{
  "npi": "1114915675",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "STEPHEN",
    "authorized_official_last_name": "MILLER",
    "authorized_official_middle_name": "P",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "3129942306",
    "authorized_official_title_or_position": "Principal/Member",
    "certification_date": "2024-03-18",
    "enumeration_date": "2005-10-10",
    "last_updated": "2024-03-18",
    "organization_name": "HELIA HEALTHCARE OF JERSEYVILLE LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "1001 S STATE ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "JERSEYVILLE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "618-498-7435",
      "postal_code": "620522361",
      "state": "IL",
      "telephone_number": "618-498-6496"
    },
    {
      "address_1": "500 NW PLAZA DR STE 712",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "SAINT ANN",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "312-896-5951",
      "postal_code": "630742222",
      "state": "MO",
      "telephone_number": "314-317-2003"
    }
  ],
  "taxonomies": [
    {
      "code": "314000000X",
      "desc": "Skilled Nursing Facility",
      "license": "1584531",
      "primary": true,
      "state": "IL",
      "taxonomy_group": ""
    },
    {
      "code": "332B00000X",
      "desc": "Durable Medical Equipment & Medical Supplies",
      "license": null,
      "primary": false,
      "state": null,
      "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 Skilled Nursing & Inpatient Post-Acute Rehabilitation Facility (SNF)",
    "certifying_board": "CMS Five-Star Quality Rating System / State Department of Health",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "A1[8]",
        "medicare_type": "Skilled Nursing Facility"
      }
    ]
  }
}