{"npi":"1083614564","type":"NPI-2","status":"active","name":{"display":"South Park Medical Clinic PA","other":[],"organization_name":"SOUTH PARK MEDICAL CLINIC PA","authorised_official":"Elbert Rudisill"},"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":"NC","license":"21863"}]},"addresses":[{"purpose":"LOCATION","street_1":"133 1ST AVE SE","city":"HICKORY","state":"NC","postal_code":"286023005","country_code":"US","phone":"8283225915","fax":"8283450387"},{"purpose":"MAILING","street_1":"133 1ST AVE SE","city":"HICKORY","state":"NC","postal_code":"286023005","country_code":"US","phone":"8283225915","fax":"8283450387"}],"license":{"state":"NC","number":"21863"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"8902716","state":"NC","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2005-07-27","last_updated":"2020-08-22","_meta":{"source":"NPPES","snapshot_date":"2020-08-22","doc_url":"https://findmynpi.com/api"}}