{
  "npi": "1982648770",
  "enumeration_type": "NPI-1",
  "basic": {
    "credential": "R.PH..",
    "enumeration_date": "2006-06-15",
    "first_name": "ROBERT",
    "last_name": "STACK",
    "last_updated": "2026-07-13",
    "middle_name": "H.",
    "name_prefix": "--",
    "name_suffix": "--",
    "sex": "M",
    "sole_proprietor": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "PO BOX 237",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "WASHINGTON DEPOT",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "860-927-0015",
      "postal_code": "067940237",
      "state": "CT",
      "telephone_number": "860-371-4502"
    },
    {
      "address_1": "3 MAPLE ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "KENT",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "860-927-0015",
      "postal_code": "067571711",
      "state": "CT",
      "telephone_number": "860-371-4502"
    }
  ],
  "taxonomies": [
    {
      "code": "1835P1200X",
      "desc": "Pharmacist, Pharmacotherapy",
      "license": "5558",
      "primary": true,
      "state": "CT",
      "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 & Credentialed Pharmacist, Pharmacotherapy",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": []
  }
}