{
  "npi": "1962657783",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "AZAM",
    "authorized_official_last_name": "KHAN",
    "authorized_official_middle_name": "S",
    "authorized_official_telephone_number": "9287573636",
    "authorized_official_title_or_position": "Chief Administrative Officer",
    "enumeration_date": "2008-11-20",
    "last_updated": "2018-06-04",
    "organization_name": "ARIZONA INSTITURE OF MEDICINE & SURGERY",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "3636 STOCKTON HILL RD",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "KINGMAN",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "928-757-3614",
      "postal_code": "86409",
      "state": "AZ",
      "telephone_number": "928-757-3680"
    },
    {
      "address_1": "3636 STOCKTON HILL RD",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "KINGMAN",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "928-757-3614",
      "postal_code": "864090514",
      "state": "AZ",
      "telephone_number": "928-757-3680"
    }
  ],
  "taxonomies": [
    {
      "code": "261QU0200X",
      "desc": "Clinic/Center, Urgent Care",
      "license": "OTC-0660",
      "primary": false,
      "state": "AZ",
      "taxonomy_group": ""
    },
    {
      "code": "335V00000X",
      "desc": "Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier",
      "license": "OTC-0660",
      "primary": false,
      "state": "AZ",
      "taxonomy_group": ""
    },
    {
      "code": "291U00000X",
      "desc": "Clinical Medical Laboratory",
      "license": "03D0534286",
      "primary": true,
      "state": "AZ",
      "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": "CLIA-Certified Diagnostic Medical & Pathology Laboratory",
    "certifying_board": "CMS CLIA / College of American Pathologists (CAP)",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "69",
        "medicare_type": "Clinical Laboratory"
      },
      {
        "medicare_code": "B4[14]",
        "medicare_type": "Histocompatibility Laboratory"
      }
    ]
  }
}