{
  "npi": "1790195717",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "MONICA",
    "authorized_official_last_name": "BOWMAN",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "6159207000",
    "authorized_official_title_or_position": "President",
    "certification_date": "2022-09-24",
    "enumeration_date": "2014-04-29",
    "last_updated": "2022-09-24",
    "organization_name": "BOURBON PHYSICIAN PRACTICE LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "9 LINVILLE DR",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "PARIS",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "403612129",
      "state": "KY",
      "telephone_number": "859-987-3600"
    },
    {
      "address_1": "330 SEVEN SPRINGS WAY",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "BRENTWOOD",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "615-920-8775",
      "postal_code": "370275098",
      "state": "TN",
      "telephone_number": "615-920-7000"
    }
  ],
  "taxonomies": [
    {
      "code": "363A00000X",
      "desc": "Physician Assistant",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "363LF0000X",
      "desc": "Nurse Practitioner, Family",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "101YP2500X",
      "desc": "Counselor, Professional",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "1041C0700X",
      "desc": "Social Worker, Clinical",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "207Y00000X",
      "desc": "Otolaryngology",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "2084N0400X",
      "desc": "Psychiatry & Neurology, Neurology",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "231H00000X",
      "desc": "Audiologist",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "207Q00000X",
      "desc": "Family Medicine",
      "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": "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"
      }
    ]
  }
}