{
  "npi": "1215102215",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "RN",
    "authorized_official_first_name": "TAVONIA",
    "authorized_official_last_name": "RUSSELL",
    "authorized_official_middle_name": "SIDONEY",
    "authorized_official_name_prefix": "Mrs.",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "3104626082",
    "authorized_official_title_or_position": "DIRECTOR",
    "enumeration_date": "2008-04-30",
    "last_updated": "2009-02-19",
    "organization_name": "AIVA HEALTH SERVICES",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "17810 ELM CT",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "CARSON",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "310-638-3549",
      "postal_code": "907467429",
      "state": "CA",
      "telephone_number": "310-462-6082"
    },
    {
      "address_1": "8453 S VAN NESS AVE",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "INGLEWOOD",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "323-778-2477",
      "postal_code": "903051519",
      "state": "CA",
      "telephone_number": "323-778-1177"
    }
  ],
  "taxonomies": [
    {
      "code": "261Q00000X",
      "desc": "Clinic/Center",
      "license": "FNP 38172",
      "primary": true,
      "state": "CA",
      "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": "70",
        "medicare_type": "Clinic or Group Practice"
      }
    ]
  }
}