{
  "npi": "1477284735",
  "enumeration_type": "NPI-1",
  "basic": {
    "certification_date": "2025-12-20",
    "enumeration_date": "2022-06-18",
    "first_name": "MARVI",
    "last_name": "BALOCH",
    "last_updated": "2025-12-20",
    "middle_name": "IBRAHIM",
    "name_prefix": "Dr.",
    "sex": "F",
    "sole_proprietor": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "2601 N JOHN B DENNIS HWY APT 104",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "KINGSPORT",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "376605872",
      "state": "TN",
      "telephone_number": "703-901-3571"
    },
    {
      "address_1": "3401 COMMISSION CT STE 201",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "LAKE RIDGE",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "221921771",
      "state": "VA",
      "telephone_number": "540-779-5180"
    }
  ],
  "taxonomies": [
    {
      "code": "207Q00000X",
      "desc": "Family Medicine",
      "license": "0101287743",
      "primary": false,
      "state": "VA",
      "taxonomy_group": ""
    },
    {
      "code": "390200000X",
      "desc": "Student in an Organized Health Care Education/Training Program",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_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 Student in an Organized Health Care Education/Training Program",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": []
  }
}