{"npi":"1134874654","type":"NPI-2","status":"active","name":{"display":"Southshore Physical Therapy PLLC","other":[],"organization_name":"SOUTHSHORE PHYSICAL THERAPY PLLC","authorised_official":"Nicholas Miller"},"specialty":{"primary_taxonomy":"225100000X","primary_taxonomy_description":"Physical Therapist","slug":"physical-therapist","schema_org_specialty":null,"all":[{"code":"225100000X","description":"Physical Therapist","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"104 12TH AVE NW UNIT 5","city":"HAZEN","state":"ND","postal_code":"585454106","country_code":"US","phone":"7018912043"},{"purpose":"MAILING","street_1":"104 12TH AVE NW UNIT 5","city":"HAZEN","state":"ND","postal_code":"585454106","country_code":"US","phone":"7018912043"}],"license":null,"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20220819002668","type_code":"12-65","type_desc":"PART B SUPPLIER - PHYSICAL/OCCUPATIONAL THERAPY GROUP IN PRIVATE PRACTICE","state":"ND","pac_id":"9830572080"}]},"enumeration_date":"2022-02-14","last_updated":"2022-02-14","_meta":{"source":"NPPES","snapshot_date":"2022-02-14","doc_url":"https://findmynpi.com/api"}}