{
  "npi": "1790827400",
  "enumeration_type": "NPI-1",
  "basic": {
    "credential": "M.A.,CCC-SLP",
    "enumeration_date": "2007-02-12",
    "first_name": "AMY",
    "last_name": "BRUECKNER",
    "last_updated": "2007-07-08",
    "middle_name": "ELIZABETH",
    "name_prefix": "Mrs.",
    "name_suffix": "--",
    "sex": "F",
    "sole_proprietor": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "414 KNOX ST",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "JACKSON",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "637552012",
      "state": "MO",
      "telephone_number": "573-204-7861"
    },
    {
      "address_1": "414 KNOX ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "JACKSON",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "637552012",
      "state": "MO",
      "telephone_number": "573-204-7861"
    }
  ],
  "taxonomies": [
    {
      "code": "235Z00000X",
      "desc": "Speech-Language Pathologist,  ",
      "license": "2005001727",
      "primary": true,
      "state": "MO",
      "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 Speech, Language and Hearing Service Providers",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "15",
        "medicare_type": "Speech Language Pathologist"
      }
    ]
  }
}