{"npi":"1104848662","type":"NPI-1","status":"active","name":{"display":"Dr. Michael Nellestein M.D.","other":[],"first":"MICHAEL","last":"NELLESTEIN","middle":"E.","credential":"M.D."},"specialty":{"primary_taxonomy":"202K00000X","primary_taxonomy_description":"Phlebology Physician","slug":"phlebology-physician","schema_org_specialty":null,"all":[{"code":"202K00000X","description":"Phlebology Physician","primary":true,"state":"MO","license":"101630"}]},"addresses":[{"purpose":"LOCATION","street_1":"1341 VILLAGE DR","city":"SAINT JOSEPH","state":"MO","postal_code":"645062457","country_code":"US","phone":"8162914149","fax":"8168973969"},{"purpose":"MAILING","street_1":"1341 VILLAGE DR","city":"SAINT JOSEPH","state":"MO","postal_code":"645062457","country_code":"US","phone":"8162914149","fax":"8168973969"}],"license":{"state":"MO","number":"101630"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"208881938","state":"MO","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20051213000620","type_code":"14-77","type_desc":"PRACTITIONER - VASCULAR SURGERY","state":"MO","pac_id":"2567416571"}]},"enumeration_date":"2006-07-24","last_updated":"2016-09-29","_meta":{"source":"NPPES","snapshot_date":"2016-09-29","doc_url":"https://findmynpi.com/api"}}