{
  "npi": "1619577657",
  "enumeration_type": "NPI-1",
  "basic": {
    "certification_date": "2020-10-28",
    "credential": "FNP-C",
    "enumeration_date": "2020-10-28",
    "first_name": "NATALIE",
    "last_name": "STEPHENS",
    "last_updated": "2020-10-28",
    "middle_name": "ANN",
    "name_prefix": "Mrs.",
    "sex": "F",
    "sole_proprietor": "YES",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "9166 US HIGHWAY 150",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "CARLOCK",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "617257504",
      "state": "IL",
      "telephone_number": "630-254-8184"
    },
    {
      "address_1": "800 NE GLEN OAK AVE",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "PEORIA",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "309-308-5095",
      "postal_code": "616033255",
      "state": "IL",
      "telephone_number": "309-308-5072"
    }
  ],
  "taxonomies": [
    {
      "code": "363L00000X",
      "desc": "Nurse Practitioner",
      "license": "209021545",
      "primary": true,
      "state": "IL",
      "taxonomy_group": "193200000X - Multi-Specialty 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 — Nurse Practitioner",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "50",
        "medicare_type": "Nurse Practitioner"
      }
    ]
  }
}