{
  "npi": "1447639802",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "LAT, CSCS, CES",
    "authorized_official_first_name": "ANDREW",
    "authorized_official_last_name": "BRAUN",
    "authorized_official_middle_name": "M",
    "authorized_official_name_prefix": "Mr.",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "9202091662",
    "authorized_official_title_or_position": "Founder/Owner",
    "enumeration_date": "2015-05-19",
    "last_updated": "2015-07-17",
    "organization_name": "ADVANCED MOVEMENT STUDIO, LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "101 W EDISON AVE",
      "address_2": "SUITE 110",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "APPLETON",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "549151367",
      "state": "WI",
      "telephone_number": "920-209-1662"
    },
    {
      "address_1": "101 W EDISON AVE",
      "address_2": "SUITE 110",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "APPLETON",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "549151367",
      "state": "WI",
      "telephone_number": "920-209-1662"
    }
  ],
  "taxonomies": [
    {
      "code": "225400000X",
      "desc": "Rehabilitation Practitioner",
      "license": "114539",
      "primary": false,
      "state": "WI",
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "2251X0800X",
      "desc": "Physical Therapist, Orthopedic",
      "license": "11251024",
      "primary": true,
      "state": "WI",
      "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": "Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist, Orthopedic",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "65",
        "medicare_type": "Physical Therapist in Private Practice"
      }
    ]
  }
}