{
  "npi": "1922060649",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "MD",
    "authorized_official_first_name": "TRACIE",
    "authorized_official_last_name": "BRYSON",
    "authorized_official_middle_name": "C",
    "authorized_official_telephone_number": "3369402407",
    "authorized_official_title_or_position": "Authorized Official",
    "certification_date": "2023-01-16",
    "enumeration_date": "2006-04-06",
    "last_updated": "2023-01-16",
    "organization_name": "DAVIE DERMATOLOGY, P.A.",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "108 DORNACH WAY",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "ADVANCE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "336-940-2409",
      "postal_code": "270067305",
      "state": "NC",
      "telephone_number": "336-940-2407"
    },
    {
      "address_1": "108 DORNACH WAY",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "ADVANCE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "336-940-2409",
      "postal_code": "270067305",
      "state": "NC",
      "telephone_number": "336-940-2407"
    }
  ],
  "taxonomies": [
    {
      "code": "174400000X",
      "desc": "Specialist",
      "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": "Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)",
    "certifying_board": "American Board of Pediatrics (ABP)",
    "cms_medicare_crosswalk": []
  }
}