{"npi":"1053684548","type":"NPI-2","status":"active","name":{"display":"Grenada Lake Medical Center","other":[],"organization_name":"GRENADA LAKE MEDICAL CENTER","authorised_official":"David Putt"},"specialty":{"primary_taxonomy":"207Q00000X","primary_taxonomy_description":"Family Medicine","slug":"family-medicine","schema_org_specialty":"PrimaryCare","all":[{"code":"207Q00000X","description":"Family Medicine","primary":true,"state":"MS","license":"21836"}]},"addresses":[{"purpose":"LOCATION","street_1":"965 AVENT DR STE 100A","city":"GRENADA","state":"MS","postal_code":"389015045","country_code":"US","phone":"6622277444","fax":"6622277443"},{"purpose":"MAILING","street_1":"965 AVENT DR STE 100A","city":"GRENADA","state":"MS","postal_code":"389015045","country_code":"US","phone":"6622277444","fax":"6622277443"}],"license":{"state":"MS","number":"21836"},"identifiers":[{"type_code":"01","label":"Other","value":"11516802","state":"MS","issuer":"CAQH"},{"type_code":"05","label":"Medicaid","value":"00059747","state":"MS","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2012-02-15","last_updated":"2014-03-18","_meta":{"source":"NPPES","snapshot_date":"2014-03-18","doc_url":"https://findmynpi.com/api"}}