{
  "npi": "1508279381",
  "enumeration_type": "NPI-1",
  "basic": {
    "certification_date": "2026-10-29",
    "credential": "PA-C",
    "enumeration_date": "2014-06-09",
    "first_name": "JEREMY",
    "last_name": "BERBEREIA",
    "last_updated": "2026-10-29",
    "sex": "M",
    "sole_proprietor": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "PO BOX 7411626",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "CHICAGO",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "606745626",
      "state": "IL"
    },
    {
      "address_1": "1150 STATE HIGHWAY 248 STE 200",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "BRANSON",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "417-335-4684",
      "postal_code": "656164186",
      "state": "MO",
      "telephone_number": "417-336-4112"
    }
  ],
  "taxonomies": [
    {
      "code": "363AM0700X",
      "desc": "Physician Assistant, Medical",
      "license": "2014017612",
      "primary": true,
      "state": "MO",
      "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 Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "97",
        "medicare_type": "Physician Assistant"
      }
    ]
  }
}