{"npi":"1134595978","type":"NPI-1","status":"active","name":{"display":"Tracy Bunnell PA-C","other":[{"code":"1","type":"Formerly known as","value":"WEIGEL, TRACY E"}],"first":"TRACY","last":"BUNNELL","middle":"E","credential":"PA-C"},"specialty":{"primary_taxonomy":"363A00000X","primary_taxonomy_description":"Physician Assistant","slug":"physician-assistant","schema_org_specialty":null,"all":[{"code":"363A00000X","description":"Physician Assistant","primary":false,"state":"WI","license":"3974"},{"code":"363A00000X","description":"Physician Assistant","primary":false,"state":"ND","license":"PAC0616"},{"code":"363A00000X","description":"Physician Assistant","primary":true,"state":"MN","license":"12367"}]},"addresses":[{"purpose":"LOCATION","street_1":"5803 NEAL AVE N","city":"OAK PARK HEIGHTS","state":"MN","postal_code":"550822177","country_code":"US","phone":"6514398807","fax":"6514390232"},{"purpose":"MAILING","street_1":"5803 NEAL AVE N","city":"OAK PARK HEIGHTS","state":"MN","postal_code":"550822177","country_code":"US","phone":"6514398807","fax":"6514390232"}],"license":{"state":"MN","number":"12367"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"1134595978","state":"MN","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20170309000532","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"MN","pac_id":"1052612421"}]},"enumeration_date":"2015-08-17","last_updated":"2017-11-29","_meta":{"source":"NPPES","snapshot_date":"2017-11-29","doc_url":"https://findmynpi.com/api"}}