{
  "npi": "1730542473",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "CARL",
    "authorized_official_last_name": "KILGORE",
    "authorized_official_middle_name": "STEVEN",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "4233023051",
    "authorized_official_title_or_position": "President",
    "enumeration_date": "2016-03-31",
    "last_updated": "2019-03-29",
    "organization_name": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "3175 LINDEN DR",
      "address_2": "STE 3",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "BRISTOL",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "276-258-4736",
      "postal_code": "242025849",
      "state": "VA",
      "telephone_number": "276-258-4734"
    },
    {
      "address_1": "3175 LINDEN DR",
      "address_2": "STE 3",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "BRISTOL",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "276-258-4736",
      "postal_code": "242025849",
      "state": "VA",
      "telephone_number": "276-258-4734"
    }
  ],
  "taxonomies": [
    {
      "code": "207QS1201X",
      "desc": "Family Medicine, Sleep Medicine",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": "193400000X - Single Specialty 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 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"
      },
      {
        "medicare_code": "C0",
        "medicare_type": "Physician/Sleep Medicine"
      }
    ]
  }
}