{"npi":"1053948562","type":"NPI-1","status":"active","name":{"display":"Mrs. Ellen Barnstable MD","other":[{"code":"1","type":"Formerly known as","value":"WRIGHT, ELLEN GRACE"}],"first":"ELLEN","last":"BARNSTABLE","middle":"GRACE","credential":"MD"},"specialty":{"primary_taxonomy":"207N00000X","primary_taxonomy_description":"Dermatology","slug":"dermatology","schema_org_specialty":"Dermatologic","all":[{"code":"390200000X","description":"Student in an Organized Health Care Education/Training Program","primary":false,"state":"IN","license":"11021938A"},{"code":"390200000X","description":"Student in an Organized Health Care Education/Training Program","primary":false,"state":null,"license":null},{"code":"207N00000X","description":"Dermatology","primary":true,"state":"WI","license":"83862-20"}]},"addresses":[{"purpose":"LOCATION","street_1":"146 E GENEVA SQ","city":"LAKE GENEVA","state":"WI","postal_code":"531479695","country_code":"US","phone":"6222495000"},{"purpose":"MAILING","street_1":"146 E GENEVA SQ","city":"LAKE GENEVA","state":"WI","postal_code":"531479695","country_code":"US","phone":"6222495000"}],"license":{"state":"WI","number":"83862-20"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"100287398","state":"WI","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20240918002528","type_code":"14-07","type_desc":"PRACTITIONER - DERMATOLOGY","state":"WI","pac_id":"9234530353"}]},"enumeration_date":"2020-03-25","last_updated":"2024-11-06","_meta":{"source":"NPPES","snapshot_date":"2024-11-06","doc_url":"https://findmynpi.com/api"}}