{
  "npi": "1205076155",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "RN",
    "authorized_official_first_name": "TRACI",
    "authorized_official_last_name": "BRISSETT",
    "authorized_official_middle_name": "S",
    "authorized_official_telephone_number": "7272868916",
    "authorized_official_title_or_position": "Director of Nursing",
    "certification_date": "2023-05-10",
    "enumeration_date": "2009-03-04",
    "last_updated": "2023-05-10",
    "organization_name": "ABUNDANT LIFE HOME HEALTH AGENCY,LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "6601 MEMORIAL HWY STE 106",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "TAMPA",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "727-724-1201",
      "postal_code": "336154501",
      "state": "FL",
      "telephone_number": "727-286-8916"
    },
    {
      "address_1": "28050 US HIGHWAY 19 N STE 205",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "CLEARWATER",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "727-724-1201",
      "postal_code": "337612627",
      "state": "FL",
      "telephone_number": "727-286-8916"
    }
  ],
  "taxonomies": [
    {
      "code": "251E00000X",
      "desc": "Home Health",
      "license": "299993080",
      "primary": true,
      "state": "FL",
      "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": "CMS-Certified Home Health Care & Skilled Nursing Agency",
    "certifying_board": "CMS Home Health Conditions of Participation / CHAP / ACHC",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "A4[11]",
        "medicare_type": "Home Health Agency"
      },
      {
        "medicare_code": "A4[11]",
        "medicare_type": "Home Health Agency (Subunit)"
      }
    ]
  }
}