{
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  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "KIMBERLY",
    "authorized_official_last_name": "GLAVESKAS",
    "authorized_official_telephone_number": "4439623945",
    "authorized_official_title_or_position": "Credentialing Supervisor",
    "certification_date": "2024-07-11",
    "enumeration_date": "2024-06-14",
    "last_updated": "2024-07-11",
    "organization_name": "BEACON BEHAVIORAL OF MISSISSIPPI, LLC",
    "organizational_subpart": "YES",
    "parent_organization_legal_business_name": "BEACON BEHAVIORAL OF MISSISSIPPI, LLC",
    "status": "A"
  },
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    {
      "address_1": "3531 LAKELAND DR STE 1060",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "FLOWOOD",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "601-420-5811",
      "postal_code": "392328016",
      "state": "MS",
      "telephone_number": "301-420-5810"
    },
    {
      "address_1": "PO BOX 306600",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "NASHVILLE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "601-420-5811",
      "postal_code": "372306600",
      "state": "TN",
      "telephone_number": "601-420-5810"
    }
  ],
  "taxonomies": [
    {
      "code": "2084P0800X",
      "desc": "Psychiatry & Neurology, Psychiatry",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": "193200000X - Multi-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 Psychiatrist (Mental Health & Behavioral Medicine Physician)",
    "certifying_board": "American Board of Psychiatry and Neurology (ABPN)",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "26",
        "medicare_type": "Physician/Psychiatry"
      },
      {
        "medicare_code": "86",
        "medicare_type": "Physician/Neuropsychiatry"
      }
    ]
  }
}