{
  "npi": "1174762512",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "ROBERT",
    "authorized_official_last_name": "TRACZ",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "4403541642",
    "authorized_official_title_or_position": "Chief Financial Officer",
    "enumeration_date": "2009-02-09",
    "last_updated": "2009-02-09",
    "organization_name": "LAKE HOSPITAL SYSTEM, INC.",
    "organizational_subpart": "NO",
    "status": "A"
  },
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    {
      "address_1": "PO BOX 714328",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "COLUMBUS",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "440-259-2106",
      "postal_code": "432714328",
      "state": "OH",
      "telephone_number": "440-375-8590"
    },
    {
      "address_1": "2 SUCCESS BLVD.",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "PERRY",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "440-259-2106",
      "postal_code": "44081",
      "state": "OH",
      "telephone_number": "440-375-8590"
    }
  ],
  "taxonomies": [
    {
      "code": "207Q00000X",
      "desc": "Family Medicine",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": "193400000X - Single 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 Family Medicine Physician (All-Ages Primary Care Doctor)",
    "certifying_board": "American Board of Family Medicine (ABFM)",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "08",
        "medicare_type": "Physician/Family Practice"
      }
    ]
  }
}