{"npi":"1174929095","type":"NPI-1","status":"active","name":{"display":"Mrs. Carly Gray PA","other":[{"code":"1","type":"Formerly known as","value":"SMITH, CARLY J"}],"first":"CARLY","last":"GRAY","middle":"JEAN","credential":"PA"},"specialty":{"primary_taxonomy":"363AM0700X","primary_taxonomy_description":"Medical Physician Assistant","slug":"medical-physician-assistant","schema_org_specialty":null,"all":[{"code":"363AM0700X","description":"Medical Physician Assistant","primary":false,"state":"VA","license":"0110004737"},{"code":"363AM0700X","description":"Medical Physician Assistant","primary":true,"state":"NC","license":"0010-06904"}]},"addresses":[{"purpose":"LOCATION","street_1":"534 CARATOKE HWY","city":"MOYOCK","state":"NC","postal_code":"279588740","country_code":"US","phone":"2524356621","fax":"2524352685"},{"purpose":"MAILING","street_1":"PO BOX 11314","city":"BELFAST","state":"ME","postal_code":"049154004","country_code":"US","phone":"7578424481","fax":"7573123135"}],"license":{"state":"NC","number":"0010-06904"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20150106001035","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"VA","pac_id":"4385967900"},{"enrlmt_id":"I20170221001558","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"NC","pac_id":"4385967900"}]},"enumeration_date":"2014-11-05","last_updated":"2020-11-19","_meta":{"source":"NPPES","snapshot_date":"2020-11-19","doc_url":"https://findmynpi.com/api"}}