{
  "npi": "1326582008",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "D.C",
    "authorized_official_first_name": "LEO",
    "authorized_official_last_name": "GONSOWSKI",
    "authorized_official_middle_name": "RAYMOND",
    "authorized_official_name_prefix": "Dr.",
    "authorized_official_name_suffix": "III",
    "authorized_official_telephone_number": "6129632248",
    "authorized_official_title_or_position": "OWNER",
    "enumeration_date": "2016-12-14",
    "last_updated": "2018-01-03",
    "organization_name": "DOCTORLEO LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "227 MERIDIAN DR",
      "address_2": "STE 4",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "NEW RICHMOND",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "715-997-3019",
      "postal_code": "540172565",
      "state": "WI",
      "telephone_number": "612-963-2248"
    },
    {
      "address_1": "762 160TH ST",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "HAMMOND",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "715-997-3019",
      "postal_code": "540155011",
      "state": "WI",
      "telephone_number": "612-963-2248"
    }
  ],
  "taxonomies": [
    {
      "code": "111N00000X",
      "desc": "Chiropractor",
      "license": "3847-012",
      "primary": true,
      "state": "WI",
      "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 Chiropractic Providers — Chiropractor",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "35",
        "medicare_type": "Chiropractic"
      }
    ]
  }
}