{
  "npi": "1689863995",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "MARK",
    "authorized_official_last_name": "BENNALLACK",
    "authorized_official_middle_name": "W",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "7142894693",
    "authorized_official_title_or_position": "Co Owner",
    "enumeration_date": "2007-10-23",
    "last_updated": "2008-06-24",
    "organization_name": "1ST INDUSTRIAL MEDICAL GROUP",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "taxonomies": [
    {
      "code": "111N00000X",
      "desc": "Chiropractor",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "207LP2900X",
      "desc": "Anesthesiology, Pain Medicine",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "207R00000X",
      "desc": "Internal Medicine",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "207XX0004X",
      "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "208100000X",
      "desc": "Physical Medicine & Rehabilitation",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "2086S0122X",
      "desc": "Surgery, Plastic and Reconstructive Surgery",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "208G00000X",
      "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "213E00000X",
      "desc": "Podiatrist",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    }
  ],
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Podiatrist",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "common_medicare_procedures": [
      "Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)",
      "Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination",
      "Preventive Screening, Patient Counseling & Multidisciplinary Referral"
    ],
    "common_part_d_therapeutic_classes": [
      "Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)"
    ]
  }
}