{
  "npi": "1316713308",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "JILL",
    "authorized_official_last_name": "PATTON",
    "authorized_official_middle_name": "JOHNSON",
    "authorized_official_telephone_number": "7049365546",
    "authorized_official_title_or_position": "Director of Risk Management",
    "certification_date": "2023-11-30",
    "enumeration_date": "2023-11-30",
    "last_updated": "2023-11-30",
    "organization_name": "EVERSIDE HEALTH MILLIKEN TWO RIVERS",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "1400 WEWATTA ST STE 350",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "DENVER",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "802025553",
      "state": "CO",
      "telephone_number": "704-661-1380"
    },
    {
      "address_1": "109 TURNER RD",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "MAYODAN",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "270278251",
      "state": "NC",
      "telephone_number": "704-661-1380"
    }
  ],
  "taxonomies": [
    {
      "code": "2083P0500X",
      "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": "193400000X - Single 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 — Preventive Medicine,  Preventive Medicine — Occupational Environmental Medicine",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "84",
        "medicare_type": "Physician/Preventive Medicine"
      }
    ]
  }
}