{
  "npi": "1205351145",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "NOREEN",
    "authorized_official_last_name": "JAHANGIRI",
    "authorized_official_middle_name": "R",
    "authorized_official_name_prefix": "Mrs.",
    "authorized_official_telephone_number": "7033380285",
    "authorized_official_title_or_position": "President",
    "certification_date": "2020-10-24",
    "enumeration_date": "2017-08-12",
    "last_updated": "2020-10-24",
    "organization_name": "EXPERIENCARE LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "502 MCKNIGHT DR STE 101",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "KNIGHTDALE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "703-991-8154",
      "postal_code": "275457050",
      "state": "NC",
      "telephone_number": "703-338-0878"
    },
    {
      "address_1": "5338 BOWERS HILL DR",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "HAYMARKET",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "201694510",
      "state": "VA",
      "telephone_number": "703-338-0285"
    }
  ],
  "taxonomies": [
    {
      "code": "273100000X",
      "desc": "Epilepsy Unit",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "292200000X",
      "desc": "Dental Laboratory",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "332B00000X",
      "desc": "Durable Medical Equipment & Medical Supplies",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "261QS1200X",
      "desc": "Clinic/Center, Sleep Disorder Diagnostic",
      "license": null,
      "primary": true,
      "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 Outpatient Medical Clinic / Urgent Care & Ambulatory Center",
    "certifying_board": "Accreditation Association for Ambulatory Health Care (AAAHC) / CMS",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "C0",
        "medicare_type": "Physician/Sleep Medicine"
      }
    ]
  }
}