{
  "npi": "1326849456",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "PATRICIA",
    "authorized_official_last_name": "MOLL",
    "authorized_official_telephone_number": "8285805003",
    "authorized_official_title_or_position": "SVP/CFO",
    "certification_date": "2025-03-24",
    "enumeration_date": "2025-03-24",
    "last_updated": "2025-03-26",
    "organization_name": "BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "720 MALCOLM BLVD",
      "address_2": "STE 400",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "VALDESE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "828-580-7624",
      "postal_code": "286902872",
      "state": "NC",
      "telephone_number": "828-580-7620"
    },
    {
      "address_1": "5221 PARAMOUNT PKWY STE 420",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "MORRISVILLE",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "275605491",
      "state": "NC",
      "telephone_number": "984-974-2705"
    }
  ],
  "taxonomies": [
    {
      "code": "208VP0014X",
      "desc": "Pain Medicine, Interventional Pain 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 — Pain Medicine, Interventional Pain Medicine",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "09",
        "medicare_type": "Physician/Interventional Pain Management"
      }
    ]
  }
}