{
  "npi": "1881921054",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "PT",
    "authorized_official_first_name": "TREVOR",
    "authorized_official_last_name": "ANDERSON",
    "authorized_official_middle_name": "S",
    "authorized_official_name_prefix": "Mr.",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "5097362225",
    "authorized_official_title_or_position": "Owner",
    "certification_date": "2020-01-07",
    "enumeration_date": "2009-11-10",
    "last_updated": "2020-01-07",
    "organization_name": "ANDERSON PHYSICAL THERAPY, LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "512 N YOUNG ST STE C",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "KENNEWICK",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "509-736-3366",
      "postal_code": "993367839",
      "state": "WA",
      "telephone_number": "509-736-2225"
    },
    {
      "address_1": "PO BOX 4764",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "WEST RICHLAND",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "509-736-3366",
      "postal_code": "993534012",
      "state": "WA",
      "telephone_number": "509-528-3308"
    }
  ],
  "taxonomies": [
    {
      "code": "261QP2000X",
      "desc": "Clinic/Center, Physical Therapy",
      "license": "602930410",
      "primary": true,
      "state": "WA",
      "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 Outpatient Medical Clinic / Urgent Care & Ambulatory Center",
    "certifying_board": "Accreditation Association for Ambulatory Health Care (AAAHC) / CMS",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "70",
        "medicare_type": "Clinic or Group Practice"
      }
    ]
  }
}