{
  "npi": "1184093262",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "FORREST",
    "authorized_official_last_name": "SIMPSON",
    "authorized_official_middle_name": "CADE",
    "authorized_official_telephone_number": "9367767028",
    "authorized_official_title_or_position": "Owner",
    "certification_date": "2026-09-03",
    "enumeration_date": "2015-09-18",
    "last_updated": "2026-09-03",
    "organization_name": "ATLANTIC AUDIOLOGY, LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "3840 S NOVA RD STE B1",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "PORT ORANGE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "386-767-0742",
      "postal_code": "321274244",
      "state": "FL",
      "telephone_number": "386-756-8225"
    },
    {
      "address_1": "3840 S NOVA RD STE B1",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "PORT ORANGE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "386-767-0742",
      "postal_code": "321274244",
      "state": "FL",
      "telephone_number": "386-756-8225"
    }
  ],
  "taxonomies": [
    {
      "code": "237600000X",
      "desc": "Audiologist-Hearing Aid Fitter",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "332S00000X",
      "desc": "Hearing  Aid Equipment",
      "license": null,
      "primary": false,
      "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 & Credentialed Audiologist-Hearing Aid Fitter",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": []
  }
}