{"npi":"1114483336","type":"NPI-1","status":"active","name":{"display":"Brendon Clark","other":[],"first":"BRENDON","last":"CLARK","middle":"MATTHEW"},"specialty":{"primary_taxonomy":"225100000X","primary_taxonomy_description":"Physical Therapist","slug":"physical-therapist","schema_org_specialty":null,"all":[{"code":"2255A2300X","description":"Athletic Trainer","primary":false,"state":null,"license":null},{"code":"390200000X","description":"Student in an Organized Health Care Education/Training Program","primary":false,"state":"IN","license":null},{"code":"225100000X","description":"Physical Therapist","primary":true,"state":"IN","license":"05015804A"}]},"addresses":[{"purpose":"LOCATION","street_1":"5265 E 82ND ST STE 200","city":"INDIANAPOLIS","state":"IN","postal_code":"462501627","country_code":"US","phone":"3175423723"},{"purpose":"MAILING","street_1":"8127 HEATHERY PL","city":"INDIANAPOLIS","state":"IN","postal_code":"462142280","country_code":"US","phone":"3172467549"}],"license":{"state":"IN","number":"05015804A"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20241209001936","type_code":"14-65","type_desc":"PRACTITIONER - PHYSICAL THERAPIST IN PRIVATE PRACTICE","state":"IN","pac_id":"6305372764"}]},"enumeration_date":"2019-02-12","last_updated":"2024-12-03","_meta":{"source":"NPPES","snapshot_date":"2024-12-03","doc_url":"https://findmynpi.com/api"}}