{
  "npi": "1629312335",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "CPA",
    "authorized_official_first_name": "DAVID",
    "authorized_official_last_name": "UNDERWOOD",
    "authorized_official_middle_name": "M",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "3098237135",
    "authorized_official_title_or_position": "Sr VP & CFO",
    "enumeration_date": "2012-11-19",
    "last_updated": "2014-04-24",
    "organization_name": "HERITAGE MANOR - PANA, LLC",
    "organizational_subpart": "YES",
    "parent_organization_legal_business_name": "HERITAGE ENTERPRISES, INC",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "115 W JEFFERSON ST",
      "address_2": "SUITE 401",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "BLOOMINGTON",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "309-829-5477",
      "postal_code": "617013946",
      "state": "IL",
      "telephone_number": "309-828-4361"
    },
    {
      "address_1": "1000 E 6TH ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "PANA",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "217-562-7242",
      "postal_code": "625571870",
      "state": "IL",
      "telephone_number": "217-562-2174"
    }
  ],
  "taxonomies": [
    {
      "code": "332BX2000X",
      "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
      "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 & Credentialed Suppliers — Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "B1",
        "medicare_type": "Oxygen supplier"
      }
    ]
  }
}