{
  "npi": "1316251036",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "DONALD",
    "authorized_official_last_name": "ANDERSON",
    "authorized_official_middle_name": "W",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "Jr.",
    "authorized_official_telephone_number": "4253589786",
    "authorized_official_title_or_position": "ASSISTANT SECRETARY ENROLLMENT",
    "certification_date": "2025-07-04",
    "enumeration_date": "2010-08-05",
    "last_updated": "2025-07-04",
    "organization_name": "PROVIDENCE HEALTH & SERVICES - OREGON",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "230 ROWE STREET",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "WHEELER",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "97147",
      "state": "OR",
      "telephone_number": "503-368-5182"
    },
    {
      "address_1": "PO BOX 3158",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "PORTLAND",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "972083158",
      "state": "OR"
    }
  ],
  "taxonomies": [
    {
      "code": "261Q00000X",
      "desc": "Clinic/Center",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "207RC0000X",
      "desc": "Internal Medicine, Cardiovascular Disease",
      "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": "Board-Certified Cardiologist (Heart & Blood Vessel Specialist)",
    "certifying_board": "American Board of Internal Medicine — Cardiovascular Disease",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "06",
        "medicare_type": "Physician/Cardiovascular Disease (Cardiology)"
      },
      {
        "medicare_code": "11",
        "medicare_type": "Physician/Internal Medicine"
      }
    ]
  }
}