{
  "npi": "1811052939",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "AuD",
    "authorized_official_first_name": "KEVIN",
    "authorized_official_last_name": "FLANAGAN",
    "authorized_official_middle_name": "G",
    "authorized_official_name_prefix": "Dr.",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "7169342025",
    "authorized_official_title_or_position": "Audiologist Owner",
    "certification_date": "2022-12-01",
    "enumeration_date": "2006-12-27",
    "last_updated": "2022-12-01",
    "organization_name": "LAKE SHORE AUDIOLOGY, P C",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "3085 SOUTHWESTERN BLVD STE 103",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "ORCHARD PARK",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "716-674-4834",
      "postal_code": "141271234",
      "state": "NY",
      "telephone_number": "716-674-4188"
    },
    {
      "address_1": "849 RT 5 & 20",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "IRVING",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "716-674-1836",
      "postal_code": "14081",
      "state": "NY",
      "telephone_number": "716-934-2025"
    }
  ],
  "taxonomies": [
    {
      "code": "231H00000X",
      "desc": "Audiologist",
      "license": "001421-2",
      "primary": false,
      "state": "NY",
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "237600000X",
      "desc": "Audiologist-Hearing Aid Fitter",
      "license": "15000008841",
      "primary": true,
      "state": "NY",
      "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 Audiologist-Hearing Aid Fitter",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": []
  }
}