{
  "npi": "1700136868",
  "enumeration_type": "NPI-1",
  "basic": {
    "credential": "DPT",
    "enumeration_date": "2012-09-17",
    "first_name": "TARA",
    "last_name": "BAGNE",
    "last_updated": "2019-11-26",
    "middle_name": "E",
    "sex": "F",
    "sole_proprietor": "YES",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "8077 155TH LN NW",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "RAMSEY",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "553033888",
      "state": "MN",
      "telephone_number": "715-821-0684"
    },
    {
      "address_1": "742 STERBENZ DR",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "HUDSON",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "540168327",
      "state": "WI",
      "telephone_number": "715-386-2128"
    }
  ],
  "taxonomies": [
    {
      "code": "2251P0200X",
      "desc": "Physical Therapist, Pediatrics",
      "license": "5501015984",
      "primary": true,
      "state": "MI",
      "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": "Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)",
    "certifying_board": "American Board of Pediatrics (ABP)",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "65",
        "medicare_type": "Physical Therapist in Private Practice"
      }
    ]
  }
}