{
  "npi": "1699072553",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "KIMBERLY",
    "authorized_official_last_name": "KENWORTHY",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "7163616636",
    "authorized_official_title_or_position": "Sr. Director Revenue Cycle Mgmt",
    "certification_date": "2024-09-23",
    "enumeration_date": "2011-02-11",
    "last_updated": "2024-09-23",
    "organization_name": "425 CEDARCREST ROAD OPERATING COMPANY, LP",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "425 CEDAR CREST DR",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "QUAKERTOWN",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "189511620",
      "state": "PA",
      "telephone_number": "215-804-0736"
    },
    {
      "address_1": "500 SENECA ST STE 100",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "BUFFALO",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "142041963",
      "state": "NY",
      "telephone_number": "716-361-6636"
    }
  ],
  "taxonomies": [
    {
      "code": "251J00000X",
      "desc": "Nursing Care",
      "license": "136710",
      "primary": true,
      "state": "PA",
      "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 Skilled Nursing & Inpatient Post-Acute Rehabilitation Facility (SNF)",
    "certifying_board": "CMS Five-Star Quality Rating System / State Department of Health",
    "cms_medicare_crosswalk": []
  }
}