{
  "npi": "1487022216",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "LYNN",
    "authorized_official_last_name": "WOLD",
    "authorized_official_middle_name": "R",
    "authorized_official_telephone_number": "7124232311",
    "authorized_official_title_or_position": "CEO",
    "certification_date": "2024-07-09",
    "enumeration_date": "2015-09-10",
    "last_updated": "2024-07-09",
    "organization_name": "BURGESS HEALTH CENTER",
    "organizational_subpart": "YES",
    "parent_organization_legal_business_name": "BURGESS HEALTH CENTER",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "1600 DIAMOND ST",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "ONAWA",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "712-423-9199",
      "postal_code": "510401548",
      "state": "IA",
      "telephone_number": "712-423-2311"
    },
    {
      "address_1": "153 BLAIR ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "WHITING",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "712-455-2698",
      "postal_code": "510631007",
      "state": "IA",
      "telephone_number": "712-455-2431"
    }
  ],
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    {
      "code": "207Q00000X",
      "desc": "Family Medicine",
      "license": null,
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      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "208600000X",
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    },
    {
      "code": "261QR1300X",
      "desc": "Clinic/Center, Rural Health",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "363L00000X",
      "desc": "Nurse Practitioner",
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      "primary": false,
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    }
  ],
  "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 Outpatient Medical Clinic / Urgent Care & Ambulatory Center",
    "certifying_board": "Accreditation Association for Ambulatory Health Care (AAAHC) / CMS",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "B4[14]",
        "medicare_type": "Rural Health Clinic"
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    ]
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}