{
  "npi": "1154827863",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "DPM, Medical Directo",
    "authorized_official_first_name": "HUGH",
    "authorized_official_last_name": "HALL",
    "authorized_official_middle_name": "RYAN",
    "authorized_official_telephone_number": "9285377111",
    "authorized_official_title_or_position": "Medical Director",
    "enumeration_date": "2018-04-02",
    "last_updated": "2018-06-07",
    "organization_name": "ADVANCED HEALTH AND WELLNESS AZ",
    "organizational_subpart": "NO",
    "parent_organization_legal_business_name": "ADVANCED HEALTH AND WELLNESS AZ",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "4830 HIGHWAY 260 STE 102",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "LAKESIDE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "928-532-1129",
      "postal_code": "85929",
      "state": "AZ",
      "telephone_number": "928-537-7111"
    },
    {
      "address_1": "4830 HIGHWAY 260 STE 102",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "LAKESIDE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "928-532-1129",
      "postal_code": "859295851",
      "state": "AZ",
      "telephone_number": "928-537-7111"
    }
  ],
  "taxonomies": [
    {
      "code": "261Q00000X",
      "desc": "Clinic/Center",
      "license": null,
      "primary": true,
      "state": "AZ",
      "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"
      }
    ]
  }
}