{
  "npi": "1881830495",
  "enumeration_type": "NPI-1",
  "basic": {
    "certification_date": "2020-01-13",
    "credential": "M.S., CCC-SLP",
    "enumeration_date": "2009-01-02",
    "first_name": "JACQUELINE",
    "last_name": "KIMBALL",
    "last_updated": "2020-01-13",
    "middle_name": "M",
    "name_prefix": "Ms.",
    "sex": "F",
    "sole_proprietor": "YES",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "4148 SEEBER RD",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "CANASTOTA",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "130323100",
      "state": "NY",
      "telephone_number": "315-264-2278"
    },
    {
      "address_1": "130 E. STATE ST.",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "SHERRILL",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "13461",
      "state": "NY",
      "telephone_number": "315-231-5250"
    }
  ],
  "taxonomies": [
    {
      "code": "252Y00000X",
      "desc": "Early Intervention Provider Agency",
      "license": null,
      "primary": false,
      "state": "NY",
      "taxonomy_group": ""
    },
    {
      "code": "235Z00000X",
      "desc": "Speech-Language Pathologist,  ",
      "license": "024400-1",
      "primary": true,
      "state": "NY",
      "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"
      }
    ]
  }
}