{"npi":"1245253160","type":"NPI-2","status":"active","name":{"display":"Park Duvalle Community Health Center, Inc.","other":[],"organization_name":"PARK DUVALLE COMMUNITY HEALTH CENTER, INC.","authorised_official":"Swannie Jett"},"specialty":{"primary_taxonomy":"261QF0400X","primary_taxonomy_description":"Federally Qualified Health Center","slug":"fqhc","schema_org_specialty":"PrimaryCare","all":[{"code":"261QF0400X","description":"Federally Qualified Health Center","primary":true,"state":"KY","license":"700005"}]},"addresses":[{"purpose":"LOCATION","street_1":"3015 WILSON AVE","city":"LOUISVILLE","state":"KY","postal_code":"402111969","country_code":"US","phone":"5027744401","fax":"5027724783"},{"purpose":"MAILING","street_1":"3015 WILSON AVE","city":"LOUISVILLE","state":"KY","postal_code":"402111969","country_code":"US","phone":"5027744401","fax":"5027724783"}],"license":{"state":"KY","number":"700005"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"31000011","state":"KY","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20040323000421","type_code":"00-04","type_desc":"PART A PROVIDER - FEDERALLY QUALIFIED HEALTH CENTER (FQHC)","state":"KY","pac_id":"1658268974"}]},"enumeration_date":"2006-07-25","last_updated":"2021-11-02","_meta":{"source":"NPPES","snapshot_date":"2021-11-02","doc_url":"https://findmynpi.com/api"}}