{
  "npi": "1508466509",
  "enumeration_type": "NPI-1",
  "basic": {
    "certification_date": "2020-10-28",
    "enumeration_date": "2020-10-28",
    "first_name": "TIMOTHY",
    "last_name": "ELLERMAN",
    "last_updated": "2020-10-28",
    "middle_name": "JOSEPH",
    "name_prefix": "Dr.",
    "name_suffix": "II",
    "sex": "M",
    "sole_proprietor": "YES",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "7639 S CHIMNEY PIER RD",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "VINCENNES",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "475917383",
      "state": "IN",
      "telephone_number": "812-890-5301"
    },
    {
      "address_1": "2251 E STATE HIGHWAY 54",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "LINTON",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "812-824-4353",
      "postal_code": "474419498",
      "state": "IN",
      "telephone_number": "812-847-8648"
    }
  ],
  "taxonomies": [
    {
      "code": "183500000X",
      "desc": "Pharmacist",
      "license": "26021422A",
      "primary": true,
      "state": "IN",
      "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 Pharmacist",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": []
  }
}