{
  "npi": "1184305435",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "JAMES",
    "authorized_official_last_name": "TARVER",
    "authorized_official_telephone_number": "9044032079",
    "authorized_official_title_or_position": "Director",
    "certification_date": "2025-02-04",
    "enumeration_date": "2023-07-28",
    "last_updated": "2025-02-04",
    "organization_name": "904 HEALTH, INC",
    "organizational_subpart": "YES",
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    {
      "address_1": "4427 EMERSON ST STE A",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "JACKSONVILLE",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "322074969",
      "state": "FL",
      "telephone_number": "904-659-2475"
    },
    {
      "address_1": "221 N HOGAN ST STE 118",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "JACKSONVILLE",
      "country_code": "US",
      "country_name": "United States",
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      "postal_code": "322024201",
      "state": "FL",
      "telephone_number": "904-900-1513"
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      "code": "207RI0200X",
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    },
    {
      "code": "261QC1500X",
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    {
      "code": "261QH0100X",
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      "taxonomy_group": ""
    },
    {
      "code": "261QP2300X",
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    }
  ],
  "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 Internist (Adult Diagnostic & Chronic Disease Physician)",
    "certifying_board": "American Board of Internal Medicine (ABIM)",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "11",
        "medicare_type": "Physician/Internal Medicine"
      },
      {
        "medicare_code": "44",
        "medicare_type": "Physician/Infectious Disease"
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}