{
  "npi": "1699762914",
  "enumeration_type": "NPI-1",
  "basic": {
    "credential": "MD",
    "enumeration_date": "2005-10-03",
    "first_name": "RANO",
    "last_name": "BOFILL",
    "last_updated": "2010-11-16",
    "middle_name": "SOLIDUM",
    "name_prefix": "--",
    "name_suffix": "--",
    "sex": "M",
    "sole_proprietor": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "PO BOX 56",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "MAN",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "304-583-2998",
      "postal_code": "256350056",
      "state": "WV",
      "telephone_number": "304-583-2998"
    },
    {
      "address_1": "420 TEAYS BRANCH",
      "address_2": "CAREMORE PAIN MGT",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "PAINTSVILLE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "606-789-4392",
      "postal_code": "41240",
      "state": "KY",
      "telephone_number": "606-789-7246"
    }
  ],
  "taxonomies": [
    {
      "code": "2085R0202X",
      "desc": "Radiology, Diagnostic Radiology",
      "license": "09512",
      "primary": false,
      "state": "WV",
      "taxonomy_group": ""
    },
    {
      "code": "208VP0000X",
      "desc": null,
      "license": "16535",
      "primary": true,
      "state": "KY",
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": true,
      "status": "EXCLUDED",
      "matches": [
        {
          "name": "RANO S BOFILL",
          "npi": "1699762914",
          "specialty": "FAMILY PRACTICE",
          "city": "MAN",
          "state": "WV",
          "excl_type": "1128b4",
          "excl_date": "2013-02-20",
          "statute_desc": "Sec. 1128(b)(4) — License Revocation, Suspension, or Surrender"
        }
      ],
      "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 Allopathic & Osteopathic Physicians — Pain Medicine, Pain Medicine",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "72",
        "medicare_type": "Physician/Pain Management"
      }
    ]
  }
}