{
  "npi": "1881813038",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "TRACY",
    "authorized_official_last_name": "KEIZER",
    "authorized_official_middle_name": "BETH",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "6516457277",
    "authorized_official_title_or_position": "Physician Assistant",
    "enumeration_date": "2007-04-25",
    "last_updated": "2020-08-22",
    "organization_name": "ABBOTT NORTHWESTERN HOSPITAL",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "1425 JESSAMINE AVE W",
      "address_2": "APT 208",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "SAINT PAUL",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "551082685",
      "state": "MN",
      "telephone_number": "651-645-7277"
    },
    {
      "address_1": "800 E 28TH ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "MINNEAPOLIS",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "554073723",
      "state": "MN",
      "telephone_number": "612-863-4000"
    }
  ],
  "taxonomies": [
    {
      "code": "273R00000X",
      "desc": "Psychiatric Unit",
      "license": null,
      "primary": true,
      "state": null,
      "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 Hospital Units — Psychiatric Unit",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "A0[7]",
        "medicare_type": "Hospital-Psychiatric Unit"
      }
    ]
  }
}