{
  "npi": "1790179893",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "CSA",
    "authorized_official_first_name": "RICARDO",
    "authorized_official_last_name": "CHUJUTALLI",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "9726520705",
    "authorized_official_title_or_position": "Manager/Owner",
    "enumeration_date": "2015-03-26",
    "last_updated": "2015-03-26",
    "organization_name": "247 OBGYN SURGICAL ASSISTING SERVICES",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "4924 MARSH HARRIER AVE",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "GRAND PRAIRIE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "972-752-7889",
      "postal_code": "750523057",
      "state": "TX",
      "telephone_number": "972-652-0705"
    },
    {
      "address_1": "4924 MARSH HARRIER AVE",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "GRAND PRAIRIE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "972-752-7889",
      "postal_code": "750523057",
      "state": "TX",
      "telephone_number": "972-652-0705"
    }
  ],
  "taxonomies": [
    {
      "code": "246ZC0007X",
      "desc": "Specialist/Technologist, Other, Surgical Assistant",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "363AS0400X",
      "desc": "Physician Assistant, Surgical",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": "193200000X - Multi-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": "Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Surgical",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "97",
        "medicare_type": "Physician Assistant"
      }
    ]
  }
}