{"npi":"1215915970","type":"NPI-1","status":"active","name":{"display":"Kathryn Moen MD","other":[{"code":"1","type":"Formerly known as","value":"RICHMOND, KATHRYN MARIE"}],"first":"KATHRYN","last":"MOEN","middle":"MARIE","credential":"MD"},"specialty":{"primary_taxonomy":"2080N0001X","primary_taxonomy_description":"Neonatal-Perinatal Medicine Physician","slug":"neonatal-perinatal-medicine-physician","schema_org_specialty":null,"all":[{"code":"2080N0001X","description":"Neonatal-Perinatal Medicine Physician","primary":false,"state":"CO","license":"41211"},{"code":"2080N0001X","description":"Neonatal-Perinatal Medicine Physician","primary":true,"state":"WI","license":"39141"}]},"addresses":[{"purpose":"LOCATION","street_1":"1836 SOUTH AVE","city":"LA CROSSE","state":"WI","postal_code":"546015429","country_code":"US","phone":"6087827300"},{"purpose":"MAILING","street_1":"1836 SOUTH AVE","city":"LA CROSSE","state":"WI","postal_code":"546015429","country_code":"US","phone":"6087827300"}],"license":{"state":"WI","number":"39141"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"026524384","state":"CO","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20090604000482","type_code":"14-37","type_desc":"PRACTITIONER - PEDIATRIC MEDICINE","state":"WI","pac_id":"1052460862"}]},"enumeration_date":"2006-01-04","last_updated":"2017-05-18","_meta":{"source":"NPPES","snapshot_date":"2017-05-18","doc_url":"https://findmynpi.com/api"}}