{
  "npi": "1992907067",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "PT",
    "authorized_official_first_name": "JERRY",
    "authorized_official_last_name": "FENTER",
    "authorized_official_middle_name": "E",
    "authorized_official_name_prefix": "Mr.",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "8707616463",
    "authorized_official_title_or_position": "Co-owner Physical Therapist",
    "certification_date": "2025-07-29",
    "enumeration_date": "2007-06-01",
    "last_updated": "2025-07-29",
    "organization_name": "FENTER PHYSICAL THERAPY LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "2860 I-55 SERVICE ROAD",
      "address_2": "SUITE C",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "MARION",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "72364",
      "state": "AR",
      "telephone_number": "870-629-9413"
    },
    {
      "address_1": "PO BOX 1429",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "MARION",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "723641429",
      "state": "AR",
      "telephone_number": "870-761-1790"
    }
  ],
  "taxonomies": [
    {
      "code": "225100000X",
      "desc": "Physical Therapist",
      "license": "PT2812",
      "primary": false,
      "state": "AR",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "225100000X",
      "desc": "Physical Therapist",
      "license": "PT2837",
      "primary": true,
      "state": "AR",
      "taxonomy_group": "193400000X - Multiple 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 Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "65",
        "medicare_type": "Physical Therapist in Private Practice"
      }
    ]
  }
}