{
  "npi": "1619172236",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "MIKE",
    "authorized_official_last_name": "KALBAUGH",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "3368788824",
    "authorized_official_title_or_position": "Credentialing Specialist",
    "enumeration_date": "2007-06-15",
    "last_updated": "2017-07-24",
    "organization_name": "ADVANCED HOME CARE, INC.",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "105 JACK WHITE DR",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "KINGSPORT",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "800-311-7783",
      "postal_code": "376642364",
      "state": "TN",
      "telephone_number": "423-230-8485"
    },
    {
      "address_1": "PO BOX 18049",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "GREENSBORO",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "800-311-7783",
      "postal_code": "274198049",
      "state": "NC",
      "telephone_number": "336-878-8950"
    }
  ],
  "taxonomies": [
    {
      "code": "332BC3200X",
      "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
      "license": null,
      "primary": false,
      "state": "TN",
      "taxonomy_group": ""
    },
    {
      "code": "332BN1400X",
      "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
      "license": null,
      "primary": false,
      "state": "TN",
      "taxonomy_group": ""
    },
    {
      "code": "332BP3500X",
      "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
      "license": "0000002963",
      "primary": false,
      "state": "TN",
      "taxonomy_group": ""
    },
    {
      "code": "332BX2000X",
      "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
      "license": null,
      "primary": false,
      "state": "TN",
      "taxonomy_group": ""
    },
    {
      "code": "333600000X",
      "desc": "Pharmacy",
      "license": "0000002963",
      "primary": false,
      "state": "TN",
      "taxonomy_group": ""
    },
    {
      "code": "3336H0001X",
      "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
      "license": "0000002963",
      "primary": false,
      "state": "TN",
      "taxonomy_group": ""
    },
    {
      "code": "332B00000X",
      "desc": "Durable Medical Equipment & Medical Supplies",
      "license": null,
      "primary": true,
      "state": "TN",
      "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 Suppliers — Durable Medical Equipment & Medical Supplies",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "54",
        "medicare_type": "Other Medical Supply Company"
      },
      {
        "medicare_code": "58",
        "medicare_type": "Medical Supply Company with Pharmacist"
      },
      {
        "medicare_code": "87[3]",
        "medicare_type": "All Other Suppliers"
      },
      {
        "medicare_code": "A2[9]",
        "medicare_type": "Intermediate Care Nursing Facility"
      },
      {
        "medicare_code": "A6",
        "medicare_type": "Medical Supply Company with Respiratory Therapist"
      },
      {
        "medicare_code": "A7",
        "medicare_type": "Department Store"
      },
      {
        "medicare_code": "A8",
        "medicare_type": "Grocery Store"
      },
      {
        "medicare_code": "B3",
        "medicare_type": "Medical supply company with pedorthic personnel"
      }
    ]
  }
}