{
  "npi": "1912664921",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "MA, CCC-SLP",
    "authorized_official_first_name": "AUTUMN",
    "authorized_official_last_name": "NOBLES",
    "authorized_official_telephone_number": "9803496233",
    "authorized_official_title_or_position": "Speech-Language Pathologist",
    "certification_date": "2021-11-29",
    "enumeration_date": "2021-11-24",
    "last_updated": "2021-11-29",
    "organization_name": "FOUR SEASONS THERAPY, PLLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "492 MAJESTIC CT SE",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "CONCORD",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "280259676",
      "state": "NC"
    },
    {
      "address_1": "8594 PARK DRIVE",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "MOUNT PLEASANT",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "281249676",
      "state": "NC",
      "telephone_number": "980-349-6233"
    }
  ],
  "taxonomies": [
    {
      "code": "235Z00000X",
      "desc": "Speech-Language Pathologist,  ",
      "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 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"
      }
    ]
  }
}