{
  "npi": "1699849885",
  "enumeration_type": "NPI-1",
  "basic": {
    "credential": "MD",
    "enumeration_date": "2006-11-20",
    "first_name": "LUIS",
    "last_name": "COLLAZO",
    "last_updated": "2011-08-22",
    "name_prefix": "--",
    "name_suffix": "--",
    "sex": "M",
    "sole_proprietor": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "31022 UTICA RD.",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "FRASER",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "586-298-6099",
      "postal_code": "48026",
      "state": "MI",
      "telephone_number": "586-298-6035"
    },
    {
      "address_1": "31022 UTICA RD.",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "FRASER",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "586-298-6099",
      "postal_code": "48026",
      "state": "MI",
      "telephone_number": "586-298-6035"
    }
  ],
  "taxonomies": [
    {
      "code": "207Q00000X",
      "desc": "Family Medicine",
      "license": "LC062191",
      "primary": true,
      "state": "MI",
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": true,
      "status": "EXCLUDED",
      "matches": [
        {
          "name": "LUIS COLLAZO",
          "npi": "1699849885",
          "specialty": "FAMILY PRACTICE",
          "city": "FARMINGTON",
          "state": "MI",
          "excl_type": "1128a4",
          "excl_date": "2015-08-20",
          "statute_desc": "Sec. 1128(a)(4) — Felony Controlled Substance Conviction"
        }
      ],
      "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 Family Medicine Physician (All-Ages Primary Care Doctor)",
    "certifying_board": "American Board of Family Medicine (ABFM)",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "08",
        "medicare_type": "Physician/Family Practice"
      }
    ]
  }
}