{
  "npi": "1407276793",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "TRACY",
    "authorized_official_last_name": "WALLS",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "9722344740",
    "authorized_official_title_or_position": "Manager",
    "enumeration_date": "2014-04-24",
    "last_updated": "2016-06-06",
    "organization_name": "ADDISON HEADACHE ASSOCIATES, LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "PO BOX 674183",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "DALLAS",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "972-346-8015",
      "postal_code": "752674183",
      "state": "TX",
      "telephone_number": "972-479-1115"
    },
    {
      "address_1": "17051 DALLAS PKWY",
      "address_2": "STE 100",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "ADDISON",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "972-231-7095",
      "postal_code": "750017101",
      "state": "TX",
      "telephone_number": "469-916-0521"
    }
  ],
  "taxonomies": [
    {
      "code": "261Q00000X",
      "desc": "Clinic/Center",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "367500000X",
      "desc": "Nurse Anesthetist, Certified Registered",
      "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 Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "43",
        "medicare_type": "Certified Registered Nurse Anesthetist (CRNA)"
      }
    ]
  }
}