{
  "npi": "1356835862",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "Nurse practitioner",
    "authorized_official_first_name": "DESHAE",
    "authorized_official_last_name": "MARTIN",
    "authorized_official_telephone_number": "8135857708",
    "authorized_official_title_or_position": "Administrative Director",
    "certification_date": "2021-06-11",
    "enumeration_date": "2018-06-18",
    "last_updated": "2021-06-11",
    "organization_name": "BAY AREA DIRECT CLIENT CARE LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "2105 ROANOKE SPRINGS DR",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "RUSKIN",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "335706312",
      "state": "FL"
    },
    {
      "address_1": "110 LITHIA PINECREST RD STE B",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "BRANDON",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "335115300",
      "state": "FL",
      "telephone_number": "813-679-5122"
    }
  ],
  "taxonomies": [
    {
      "code": "373H00000X",
      "desc": "Day Training/Habilitation Specialist",
      "license": null,
      "primary": false,
      "state": "FL",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "251E00000X",
      "desc": "Home Health",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "251J00000X",
      "desc": "Nursing Care",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "313M00000X",
      "desc": "Nursing Facility/Intermediate Care Facility",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "320900000X",
      "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "385HR2060X",
      "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "207RI0001X",
      "desc": "Internal Medicine, Clinical & Laboratory Immunology",
      "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 Internist (Adult Diagnostic & Chronic Disease Physician)",
    "certifying_board": "American Board of Internal Medicine (ABIM)",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "11",
        "medicare_type": "Physician/Internal Medicine"
      }
    ]
  }
}