{
  "npi": "1942105952",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "AMANDA",
    "authorized_official_last_name": "SCOTT",
    "authorized_official_name_prefix": "Ms.",
    "authorized_official_telephone_number": "8032397513",
    "authorized_official_title_or_position": "Director",
    "certification_date": "2026-10-09",
    "enumeration_date": "2026-10-09",
    "last_updated": "2026-10-09",
    "organization_name": "EMPIRE MOBILE LAB",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "1969 GLENN RD",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "GASTON",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "290539393",
      "state": "SC",
      "telephone_number": "803-239-7513"
    },
    {
      "address_1": "1969 GLENN RD",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "GASTON",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "290539393",
      "state": "SC",
      "telephone_number": "803-239-7513"
    }
  ],
  "taxonomies": [
    {
      "code": "202K00000X",
      "desc": "Phlebology",
      "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 Phlebology",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": []
  }
}