{
  "npi": "1639588965",
  "enumeration_type": "NPI-1",
  "basic": {
    "certification_date": "2022-08-17",
    "credential": "OD",
    "enumeration_date": "2014-08-12",
    "first_name": "STEPHANIE",
    "last_name": "LONG",
    "last_updated": "2022-08-17",
    "middle_name": "C.",
    "sex": "F",
    "sole_proprietor": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "PO BOX 207158",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "DALLAS",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "636-527-0766",
      "postal_code": "753207158",
      "state": "TX",
      "telephone_number": "636-200-4393"
    },
    {
      "address_1": "2185 S MASON RD",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "SAINT LOUIS",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "631311640",
      "state": "MO",
      "telephone_number": "314-821-5666"
    }
  ],
  "taxonomies": [
    {
      "code": "152W00000X",
      "desc": "Optometrist",
      "license": "2014028346",
      "primary": true,
      "state": "MO",
      "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 Eye and Vision Service Providers — Optometrist",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "41",
        "medicare_type": "Optometry"
      }
    ]
  }
}