{
  "npi": "1255091955",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "MD",
    "authorized_official_first_name": "CHARLES",
    "authorized_official_last_name": "MCGLADE",
    "authorized_official_middle_name": "T",
    "authorized_official_telephone_number": "5036837730",
    "authorized_official_title_or_position": "President",
    "certification_date": "2021-12-21",
    "enumeration_date": "2021-12-21",
    "last_updated": "2021-12-21",
    "organization_name": "ADVANCED VASCULAR CENTERS EUGENE LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "1200 GATEWAY LOOP",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "SPRINGFIELD",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "974771176",
      "state": "OR",
      "telephone_number": "503-683-7730"
    },
    {
      "address_1": "1200 GATEWAY LOOP",
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      "country_code": "US",
      "country_name": "United States",
      "postal_code": "974771176",
      "state": "OR",
      "telephone_number": "503-683-7730"
    }
  ],
  "taxonomies": [
    {
      "code": "207RN0300X",
      "desc": "Internal Medicine, Nephrology",
      "license": null,
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      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "2086S0129X",
      "desc": null,
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "2085R0204X",
      "desc": "Radiology, Vascular & Interventional Radiology",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty 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 & Credentialed Allopathic & Osteopathic Physicians — Radiology, Vascular and Interventional Radiology",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "94",
        "medicare_type": "Physician/Interventional Radiology"
      }
    ]
  }
}