{
  "npi": "1912056326",
  "enumeration_type": "NPI-1",
  "basic": {
    "credential": "MD",
    "enumeration_date": "2007-01-09",
    "first_name": "JORGE",
    "last_name": "FERNALD",
    "last_updated": "2018-08-23",
    "middle_name": "E",
    "sex": "M",
    "sole_proprietor": "YES",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "7300 W COLLEGE DR",
      "address_2": "SUITE #101",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "PALOS HEIGHTS",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "60463",
      "state": "IL",
      "telephone_number": "708-448-8470"
    },
    {
      "address_1": "7300 W COLLEGE DR",
      "address_2": "SUITE #101",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "PALOS HEIGHTS",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "604631152",
      "state": "IL",
      "telephone_number": "708-448-8470"
    }
  ],
  "taxonomies": [
    {
      "code": "2084P0800X",
      "desc": "Psychiatry & Neurology, Psychiatry",
      "license": "036-085526",
      "primary": false,
      "state": "IL",
      "taxonomy_group": ""
    },
    {
      "code": "2084P0804X",
      "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
      "license": "036-095526",
      "primary": true,
      "state": "IL",
      "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": "Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist)",
    "certifying_board": "American Board of Psychiatry and Neurology (ABPN)",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "86",
        "medicare_type": "Physician/Neuropsychiatry"
      }
    ]
  }
}