{
  "npi": "1568651099",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "LISA",
    "authorized_official_last_name": "BLOEMER",
    "authorized_official_middle_name": "MARIE",
    "authorized_official_name_prefix": "Miss",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "2175622544",
    "authorized_official_title_or_position": "OFFICE MANAGER",
    "certification_date": "2025-04-17",
    "enumeration_date": "2007-10-22",
    "last_updated": "2025-04-17",
    "organization_name": "PANA COMMUNITY HOSPITAL ASSOCIATION",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "103 W 6TH ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "RAMSEY",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "618-423-1208",
      "postal_code": "620800016",
      "state": "IL",
      "telephone_number": "217-562-6246"
    },
    {
      "address_1": "715 SOUTH SUPERIOR",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "RAMSEY",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "618-423-1208",
      "postal_code": "62080",
      "state": "IL",
      "telephone_number": "618-423-2412"
    }
  ],
  "taxonomies": [
    {
      "code": "207Q00000X",
      "desc": "Family Medicine",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193400000X - Single Specialty Group"
    },
    {
      "code": "261QM1300X",
      "desc": "Clinic/Center, Multi-Specialty",
      "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 Outpatient Medical Clinic / Urgent Care & Ambulatory Center",
    "certifying_board": "Accreditation Association for Ambulatory Health Care (AAAHC) / CMS",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "70",
        "medicare_type": "Clinic or Group Practice"
      }
    ]
  }
}