{
  "npi": "1619717782",
  "enumeration_type": "NPI-1",
  "basic": {
    "certification_date": "2026-11-02",
    "enumeration_date": "2024-05-28",
    "first_name": "TAYLOR",
    "last_name": "BEARDT",
    "last_updated": "2026-11-02",
    "middle_name": "RENEE",
    "sex": "F",
    "sole_proprietor": "YES",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "4640 LA CRESCENTA AVE",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "LA CRESCENTA",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "912142916",
      "state": "CA",
      "telephone_number": "818-279-4620"
    },
    {
      "address_1": "6621 FANNIN ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "HOUSTON",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "770302399",
      "state": "TX",
      "telephone_number": "832-824-1000"
    }
  ],
  "taxonomies": [
    {
      "code": "363AS0400X",
      "desc": "Physician Assistant, Surgical",
      "license": "68604",
      "primary": true,
      "state": "CA",
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "363AS0400X",
      "desc": "Physician Assistant, Surgical",
      "license": "PA20942",
      "primary": false,
      "state": "TX",
      "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 Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Surgical",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "97",
        "medicare_type": "Physician Assistant"
      }
    ]
  }
}