{"npi":"1083610646","type":"NPI-1","status":"active","name":{"display":"Gerald Clevenger Pac","other":[],"first":"GERALD","last":"CLEVENGER","middle":"W","credential":"PAC"},"specialty":{"primary_taxonomy":"363A00000X","primary_taxonomy_description":"Physician Assistant","slug":"physician-assistant","schema_org_specialty":null,"all":[{"code":"363A00000X","description":"Physician Assistant","primary":true,"state":"KS","license":"1500117"}]},"addresses":[{"purpose":"LOCATION","street_1":"311 W. LOCUST ST.","city":"TROY","state":"KS","postal_code":"66087","country_code":"US","phone":"7859853504","fax":"7859853813"},{"purpose":"MAILING","street_1":"800 RAVENHILL DR","city":"ATCHISON","state":"KS","postal_code":"660029204","country_code":"US","phone":"9133672131","fax":"9136742024"}],"license":{"state":"KS","number":"1500117"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"30004083700001","state":"KS","issuer":null},{"type_code":"01","label":"Other","value":"016289043","state":"KS","issuer":"PTAN"},{"type_code":"05","label":"Medicaid","value":"100098780E","state":"KS","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20050531000532","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"KS","pac_id":"7012959026"}]},"enumeration_date":"2005-06-28","last_updated":"2026-03-11","_meta":{"source":"NPPES","snapshot_date":"2026-03-11","doc_url":"https://findmynpi.com/api"}}