{
  "npi": "1619148996",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "CPA",
    "authorized_official_first_name": "SAM",
    "authorized_official_last_name": "MARSH",
    "authorized_official_middle_name": "M",
    "authorized_official_name_prefix": "Mr.",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "2524436265",
    "authorized_official_title_or_position": "Vice President of Operations",
    "enumeration_date": "2008-03-14",
    "last_updated": "2008-03-14",
    "organization_name": "AUTUMN CORPORATION",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "440 INGRAM ROAD EXT",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "KING",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "336-983-4710",
      "postal_code": "270218208",
      "state": "NC",
      "telephone_number": "336-983-4900"
    },
    {
      "address_1": "440 INGRAM ROAD EXT",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "KING",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "336-983-4710",
      "postal_code": "270218208",
      "state": "NC",
      "telephone_number": "336-983-4900"
    }
  ],
  "taxonomies": [
    {
      "code": "313M00000X",
      "desc": "Nursing Facility/Intermediate Care Facility",
      "license": "NH0507",
      "primary": true,
      "state": "NC",
      "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 Nursing and Custodial Care Facilities — Nursing Facility",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "A3[10]",
        "medicare_type": "Other Nursing Facility"
      }
    ]
  }
}