{
  "npi": "1336475664",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "DPT",
    "authorized_official_first_name": "BRAD",
    "authorized_official_last_name": "GILDEN",
    "authorized_official_middle_name": "MICHAEL",
    "authorized_official_name_prefix": "Dr.",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "2039835748",
    "authorized_official_title_or_position": "Owner/Physical Therapist",
    "enumeration_date": "2009-10-21",
    "last_updated": "2010-06-08",
    "organization_name": "ELITE HEALTH SERVICES",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "76 VALLEY RD",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "COS COB",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "203-869-4420",
      "postal_code": "068072533",
      "state": "CT",
      "telephone_number": "203-983-5748"
    },
    {
      "address_1": "1445 E PUTNAM AVE",
      "address_2": "2ND FLOOR",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "OLD GREENWICH",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "203-869-4420",
      "postal_code": "068701379",
      "state": "CT",
      "telephone_number": "203-983-5748"
    }
  ],
  "taxonomies": [
    {
      "code": "225100000X",
      "desc": "Physical Therapist",
      "license": "007251",
      "primary": true,
      "state": "CT",
      "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 Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "65",
        "medicare_type": "Physical Therapist in Private Practice"
      }
    ]
  }
}