{
  "npi": "1891138780",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "GREGORY",
    "authorized_official_last_name": "DUCKETT",
    "authorized_official_middle_name": "M",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "9012275233",
    "authorized_official_title_or_position": "SR VP/ CLO",
    "certification_date": "2020-09-30",
    "enumeration_date": "2013-04-10",
    "last_updated": "2020-09-30",
    "organization_name": "BAPTIST MEDICAL CENTER - LEAKE, INC.",
    "organizational_subpart": "YES",
    "parent_organization_legal_business_name": "BAPTIST MEMORIAL HEALTH CARE CORP.",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "600 HIGHWAY 16 E",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "CARTHAGE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "601-267-6434",
      "postal_code": "390514212",
      "state": "MS",
      "telephone_number": "601-267-1480"
    },
    {
      "address_1": "350 N HUMPHREYS BLVD",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "MEMPHIS",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "601-267-6434",
      "postal_code": "381202177",
      "state": "TN",
      "telephone_number": "601-267-1480"
    }
  ],
  "taxonomies": [
    {
      "code": "363LF0000X",
      "desc": "Nurse Practitioner, Family",
      "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": "Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "50",
        "medicare_type": "Nurse Practitioner"
      }
    ]
  }
}