{
  "npi": "1639398480",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "MARK",
    "authorized_official_last_name": "QUARTERMAN",
    "authorized_official_middle_name": "JOHNSON",
    "authorized_official_telephone_number": "8642247577",
    "authorized_official_title_or_position": "Owner",
    "certification_date": "2025-09-30",
    "enumeration_date": "2007-04-24",
    "last_updated": "2025-09-30",
    "organization_name": "ANDERSON SKIN AND CANCER CLINIC PA",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "2022 CARDINAL CIR",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "ANDERSON",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "864-225-5165",
      "postal_code": "296211504",
      "state": "SC",
      "telephone_number": "864-224-7577"
    },
    {
      "address_1": "2022 CARDINAL CIR",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "ANDERSON",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "864-225-5165",
      "postal_code": "296211504",
      "state": "SC",
      "telephone_number": "864-224-7577"
    }
  ],
  "taxonomies": [
    {
      "code": "207ND0900X",
      "desc": "Dermatology, Dermatopathology",
      "license": "16908",
      "primary": true,
      "state": "SC",
      "taxonomy_group": "193400000X - Single 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": "Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist)",
    "certifying_board": "American Board of Dermatology (ABD)",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "07",
        "medicare_type": "Physician/Dermatology"
      }
    ]
  }
}