{
  "npi": "1760699896",
  "enumeration_type": "NPI-1",
  "basic": {
    "credential": "Nurse Practitioner",
    "enumeration_date": "2007-05-17",
    "first_name": "NANCY",
    "last_name": "BERGEY",
    "last_updated": "2014-01-14",
    "middle_name": "JEAN",
    "name_prefix": "--",
    "name_suffix": "--",
    "sex": "F",
    "sole_proprietor": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "N2665 COUNTY ROAD QQ",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "KING",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "715-258-0450",
      "postal_code": "549460600",
      "state": "WI",
      "telephone_number": "715-258-5586"
    },
    {
      "address_1": "N2665 COUNTY ROAD QQ",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "KING",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "715-258-0450",
      "postal_code": "549460600",
      "state": "WI",
      "telephone_number": "715-258-5586"
    }
  ],
  "taxonomies": [
    {
      "code": "163WP0808X",
      "desc": "Registered Nurse, Psych/Mental Health",
      "license": "64407",
      "primary": false,
      "state": "WI",
      "taxonomy_group": ""
    },
    {
      "code": "364SP0809X",
      "desc": "Clinical Nurse Specialist, Psych/Mental Health, Adult",
      "license": "MB2732178",
      "primary": true,
      "state": "WI",
      "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 & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health, Adult",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "89",
        "medicare_type": "Certified Clinical Nurse Specialist"
      }
    ]
  }
}