{
  "npi": "1962522078",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "DUSTIN",
    "authorized_official_last_name": "CRAGUN",
    "authorized_official_name_prefix": "Mr.",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "8016932301",
    "authorized_official_title_or_position": "General Manager",
    "enumeration_date": "2007-03-30",
    "last_updated": "2019-10-23",
    "organization_name": "ALTA THERAPIES LC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "1481 E 1450 S",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "CLEARFIELD",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "801-693-2391",
      "postal_code": "840151610",
      "state": "UT",
      "telephone_number": "801-693-2303"
    },
    {
      "address_1": "598 W 900 S STE 240",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "WOODS CROSS",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "801-693-2390",
      "postal_code": "840108195",
      "state": "UT",
      "telephone_number": "801-693-2301"
    }
  ],
  "taxonomies": [
    {
      "code": "225100000X",
      "desc": "Physical Therapist",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "225X00000X",
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      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "235Z00000X",
      "desc": "Speech-Language Pathologist,  ",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "261QM1300X",
      "desc": "Clinic/Center, Multi-Specialty",
      "license": null,
      "primary": true,
      "state": null,
      "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": "Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center",
    "certifying_board": "Accreditation Association for Ambulatory Health Care (AAAHC) / CMS",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "70",
        "medicare_type": "Clinic or Group Practice"
      }
    ]
  }
}