{
  "npi": "1780111773",
  "enumeration_type": "NPI-1",
  "basic": {
    "certification_date": "2021-05-08",
    "credential": "PA-C",
    "enumeration_date": "2017-05-22",
    "first_name": "BRIDGET",
    "last_name": "BOVICH",
    "last_updated": "2021-05-08",
    "sex": "F",
    "sole_proprietor": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "3086 KILLARNEY DR",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "PACE",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "325718430",
      "state": "FL",
      "telephone_number": "631-379-3067"
    },
    {
      "address_1": "6044 DOCTORS PARK",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "MILTON",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "325705072",
      "state": "FL",
      "telephone_number": "850-226-6801"
    }
  ],
  "taxonomies": [
    {
      "code": "363A00000X",
      "desc": "Physician Assistant",
      "license": "020808",
      "primary": false,
      "state": "NY",
      "taxonomy_group": ""
    },
    {
      "code": "363A00000X",
      "desc": "Physician Assistant",
      "license": "PA9111095",
      "primary": true,
      "state": "FL",
      "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 — Physician Assistant",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "97",
        "medicare_type": "Physician Assistant"
      }
    ]
  }
}