{
  "npi": "1124886965",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "FRANK",
    "authorized_official_last_name": "AVIGNONE",
    "authorized_official_middle_name": "TITUS",
    "authorized_official_telephone_number": "2146297860",
    "authorized_official_title_or_position": "CEO",
    "certification_date": "2024-03-07",
    "enumeration_date": "2024-03-07",
    "last_updated": "2024-03-07",
    "organization_name": "CENTENNIAL HOUSING & COMMUNITY SERVICES CORPORATION",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "104 MEDICAL DR",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "WILLIAMSTON",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "278922156",
      "state": "NC",
      "telephone_number": "217-519-9654"
    },
    {
      "address_1": "958 US HIGHWAY 64 E",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "PLYMOUTH",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "279629216",
      "state": "NC",
      "telephone_number": "252-795-4135"
    }
  ],
  "taxonomies": [
    {
      "code": "261QM1300X",
      "desc": "Clinic/Center, Multi-Specialty",
      "license": null,
      "primary": true,
      "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 Outpatient Medical Clinic / Urgent Care & Ambulatory Center",
    "certifying_board": "Accreditation Association for Ambulatory Health Care (AAAHC) / CMS",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "70",
        "medicare_type": "Clinic or Group Practice"
      }
    ]
  }
}