{
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  "enumeration_type": "NPI-2",
  "basic": {
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    "authorized_official_first_name": "KEVIN",
    "authorized_official_last_name": "LAUCK",
    "authorized_official_middle_name": "D",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "4023734341",
    "authorized_official_title_or_position": "President",
    "enumeration_date": "2016-09-30",
    "last_updated": "2016-09-30",
    "organization_name": "BLOOMFIELD MEDICAL CLINIC",
    "organizational_subpart": "YES",
    "parent_organization_legal_business_name": "BLOOMFIELD MEDICAL CLINIC PC",
    "status": "A"
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      "address_1": "105 S BROADWAY ST",
      "address_2": "PO BOX 357",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "BLOOMFIELD",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "402-373-4344",
      "postal_code": "687184419",
      "state": "NE",
      "telephone_number": "402-373-4341"
    },
    {
      "address_1": "418 N STATE ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "OSMOND",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "402-373-4344",
      "postal_code": "687655722",
      "state": "NE",
      "telephone_number": "402-748-3366"
    }
  ],
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    {
      "code": "363A00000X",
      "desc": "Physician Assistant",
      "license": "1040",
      "primary": false,
      "state": "NE",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "363A00000X",
      "desc": "Physician Assistant",
      "license": "2003",
      "primary": false,
      "state": "NE",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
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      "desc": "Nurse Practitioner, Family",
      "license": "110153",
      "primary": false,
      "state": "NE",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "207Q00000X",
      "desc": "Family Medicine",
      "license": "25844",
      "primary": true,
      "state": "NE",
      "taxonomy_group": "193400000X - Multiple 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"
      }
    ]
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}