{"npi":"1093776080","type":"NPI-1","status":"active","name":{"display":"Dr. Jerome List D.D.S., M.D.","other":[],"first":"JEROME","last":"LIST","middle":"O","credential":"D.D.S., M.D."},"specialty":{"primary_taxonomy":"207Y00000X","primary_taxonomy_description":"Otolaryngology Physician","slug":"otolaryngology-physician","schema_org_specialty":null,"all":[{"code":"207Y00000X","description":"Otolaryngology Physician","primary":false,"state":"NY","license":"329599"},{"code":"207Y00000X","description":"Otolaryngology Physician","primary":true,"state":"AK","license":"2607"}]},"addresses":[{"purpose":"LOCATION","street_1":"12641 OLD GLENN HWY STE 201","city":"EAGLE RIVER","state":"AK","postal_code":"995777040","country_code":"US","phone":"9075611421","fax":"9075610327"},{"purpose":"MAILING","street_1":"3831 PIPER ST STE S433","city":"ANCHORAGE","state":"AK","postal_code":"995086900","country_code":"US","phone":"9075611421","fax":"9075610327"}],"license":{"state":"AK","number":"2607"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"MD1123","state":"AK","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20120315000825","type_code":"14-04","type_desc":"PRACTITIONER - OTOLARYNGOLOGY","state":"AK","pac_id":"7517950603"},{"enrlmt_id":"I20240607000922","type_code":"14-04","type_desc":"PRACTITIONER - OTOLARYNGOLOGY","state":"NY","pac_id":"7517950603"}]},"enumeration_date":"2006-03-29","last_updated":"2024-04-30","_meta":{"source":"NPPES","snapshot_date":"2024-04-30","doc_url":"https://findmynpi.com/api"}}