{"npi":"1063259489","type":"NPI-1","status":"active","name":{"display":"Amanda Mcconville","other":[],"first":"AMANDA","last":"MCCONVILLE"},"specialty":{"primary_taxonomy":"363LP0808X","primary_taxonomy_description":"Psychiatric/Mental Health Nurse Practitioner","slug":"psychiatric-mental-health-nurse-practitioner","schema_org_specialty":null,"all":[{"code":"363L00000X","description":"Nurse Practitioner","primary":false,"state":"WI","license":"15536"},{"code":"363LP0808X","description":"Psychiatric/Mental Health Nurse Practitioner","primary":true,"state":"WI","license":"15536"}]},"addresses":[{"purpose":"LOCATION","street_1":"2901 HUNTERS TRL","city":"PORTAGE","state":"WI","postal_code":"539013403","country_code":"US","phone":"6087425518","fax":"6082689780"},{"purpose":"MAILING","street_1":"119 PRAIRIE HEIGHTS DR","city":"VERONA","state":"WI","postal_code":"535932333","country_code":"US","phone":"6083703641"}],"license":{"state":"WI","number":"15536"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"100367843","state":"WI","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20251030001350","type_code":"14-50","type_desc":"PRACTITIONER - NURSE PRACTITIONER","state":"WI","pac_id":"0648769679"}]},"enumeration_date":"2024-07-12","last_updated":"2026-03-27","_meta":{"source":"NPPES","snapshot_date":"2026-03-27","doc_url":"https://findmynpi.com/api"}}