{
  "npi": "1245694041",
  "enumeration_type": "NPI-1",
  "basic": {
    "certification_date": "2021-02-07",
    "credential": "DC",
    "enumeration_date": "2016-04-07",
    "first_name": "JUSTIN",
    "last_name": "ANDERSON",
    "last_updated": "2021-02-07",
    "middle_name": "MICHAEL",
    "sex": "M",
    "sole_proprietor": "YES",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "6744 N GLENWOOD ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "BOISE",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "837141926",
      "state": "ID",
      "telephone_number": "712-899-8984"
    },
    {
      "address_1": "6744 N GLENWOOD ST",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "BOISE",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "837141926",
      "state": "ID",
      "telephone_number": "712-899-8984"
    }
  ],
  "taxonomies": [
    {
      "code": "111NR0400X",
      "desc": "Chiropractor, Rehabilitation",
      "license": "CHIA-1675",
      "primary": false,
      "state": "ID",
      "taxonomy_group": "193400000X - Single Specialty Group"
    },
    {
      "code": "111N00000X",
      "desc": "Chiropractor",
      "license": "CHIA-1675",
      "primary": true,
      "state": "ID",
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": true,
      "status": "EXCLUDED",
      "matches": [
        {
          "name": "JUSTIN MICHAEL ANDERSON",
          "npi": "1245694041",
          "specialty": "CHIROPRACTIC",
          "city": "KUNA",
          "state": "ID",
          "excl_type": "1128a2",
          "excl_date": "2024-06-20",
          "statute_desc": "Sec. 1128(a)(2) — Conviction Relating to Patient Abuse or Neglect"
        }
      ],
      "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 Chiropractic Providers — Chiropractor",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "35",
        "medicare_type": "Chiropractic"
      }
    ]
  }
}