{"npi":"1194862417","type":"NPI-1","status":"active","name":{"display":"David Kelly MD","other":[],"first":"DAVID","last":"KELLY","middle":"J","credential":"MD"},"specialty":{"primary_taxonomy":"207Q00000X","primary_taxonomy_description":"Family Medicine","slug":"family-medicine","schema_org_specialty":"PrimaryCare","all":[{"code":"207Q00000X","description":"Family Medicine","primary":false,"state":"OR","license":"MD155014"},{"code":"207Q00000X","description":"Family Medicine","primary":true,"state":"ID","license":"M-17694"},{"code":"207Q00000X","description":"Family Medicine","primary":false,"state":"WI","license":"47273"},{"code":"207Q00000X","description":"Family Medicine","primary":false,"state":"ID","license":"M-9938"}]},"addresses":[{"purpose":"LOCATION","street_1":"3217 W BAVARIA ST","city":"EAGLE","state":"ID","postal_code":"836165171","country_code":"US","phone":"2083026200","fax":"2083026255"},{"purpose":"MAILING","street_1":"PO BOX 190930","city":"BOISE","state":"ID","postal_code":"837190930","country_code":"US","phone":"2083675170","fax":"2083675180"}],"license":{"state":"ID","number":"M-17694"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"807768800","state":"ID","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20070905000047","type_code":"14-08","type_desc":"PRACTITIONER - FAMILY PRACTICE","state":"ID","pac_id":"0840251740"}]},"enumeration_date":"2007-01-30","last_updated":"2024-04-04","_meta":{"source":"NPPES","snapshot_date":"2024-04-04","doc_url":"https://findmynpi.com/api"}}