{
  "npi": "1144874447",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "MSN, FNP-BC, PMHNP-B",
    "authorized_official_first_name": "DEBRA",
    "authorized_official_last_name": "MOORE-ZIEROW",
    "authorized_official_middle_name": "GIULIANA",
    "authorized_official_telephone_number": "8047253041",
    "authorized_official_title_or_position": "CEO",
    "certification_date": "2023-06-01",
    "enumeration_date": "2019-07-25",
    "last_updated": "2023-06-12",
    "organization_name": "THE CHANGING TIDE BODY, MIND & SPIRIT P.C.",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "10978 BUCKLEY HALL ROAD",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "MATHEWS",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "804-725-3510",
      "postal_code": "231092310",
      "state": "VA",
      "telephone_number": "804-725-3041"
    },
    {
      "address_1": "PO BOX 327",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "MATHEWS",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "804-725-3041",
      "postal_code": "231090327",
      "state": "VA",
      "telephone_number": "804-725-3041"
    }
  ],
  "taxonomies": [
    {
      "code": "363LP0808X",
      "desc": "Nurse Practitioner, Psych/Mental Health",
      "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": "Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "50",
        "medicare_type": "Nurse Practitioner"
      }
    ]
  }
}