{
  "npi": "1962685388",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "PT",
    "authorized_official_first_name": "KEVIN",
    "authorized_official_last_name": "ELO",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "2196633554",
    "authorized_official_title_or_position": "PRESIDENT",
    "enumeration_date": "2007-12-07",
    "last_updated": "2008-01-22",
    "organization_name": "1ST ADVANTAGE PHYSICAL THERAPY PC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "1516 N MAIN ST",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "CROWN POINT",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "219-226-0500",
      "postal_code": "463072332",
      "state": "IN",
      "telephone_number": "219-226-1500"
    },
    {
      "address_1": "1516 N MAIN ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "CROWN POINT",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "219-226-0500",
      "postal_code": "463072332",
      "state": "IN",
      "telephone_number": "219-226-1500"
    }
  ],
  "taxonomies": [
    {
      "code": "208100000X",
      "desc": "Physical Medicine & Rehabilitation",
      "license": "05005012A",
      "primary": true,
      "state": "IN",
      "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 Allopathic & Osteopathic Physicians — Physical Medicine & Rehabilitation",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "25",
        "medicare_type": "Physician/Physical Medicine and Rehabilitation"
      }
    ]
  }
}