{
  "npi": "1851491690",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "DAVID",
    "authorized_official_last_name": "FLICEK",
    "authorized_official_middle_name": "WILLIAM",
    "authorized_official_telephone_number": "6053227915",
    "authorized_official_title_or_position": "President/CEO",
    "certification_date": "2021-05-25",
    "enumeration_date": "2006-09-22",
    "last_updated": "2021-06-10",
    "organization_name": "AVERA MCKENNAN",
    "organizational_subpart": "YES",
    "parent_organization_legal_business_name": "AVERA MCKENNAN",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "2020 HOSPITAL DR., STE. 2",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "WINDOM",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "507-831-5668",
      "postal_code": "561011766",
      "state": "MN",
      "telephone_number": "507-831-1703"
    },
    {
      "address_1": "800 E 21ST STREET",
      "address_2": "PO BOX5045",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "SIOUX FALLS",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "605-322-6363",
      "postal_code": "571175045",
      "state": "SD",
      "telephone_number": "605-322-6375"
    }
  ],
  "taxonomies": [
    {
      "code": "207Q00000X",
      "desc": "Family Medicine",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": "193400000X - Single 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"
      }
    ]
  }
}