{"npi":"1265404388","type":"NPI-1","status":"active","name":{"display":"Mr. Douglas Ellis Physical Therapist","other":[],"first":"DOUGLAS","last":"ELLIS","middle":"A","credential":"PHYSICAL THERAPIST"},"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":"NV","license":"0149"}]},"addresses":[{"purpose":"LOCATION","street_1":"3233 W CHARLESTON BLVD","city":"LAS VEGAS","state":"NV","postal_code":"891021938","country_code":"US","street_2":"STE 107","phone":"7022589381","fax":"7022589584"},{"purpose":"MAILING","street_1":"790 REMINGTON BLVD","city":"BOLINGBROOK","state":"IL","postal_code":"604404909","country_code":"US","phone":"6302962223","fax":"6307599510"}],"license":{"state":"NV","number":"0149"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"1265404388","state":"NV","issuer":null},{"type_code":"01","label":"Other","value":"DL668Z","state":null,"issuer":"MEDICARE PTAN"}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-02-02","last_updated":"2015-09-03","_meta":{"source":"NPPES","snapshot_date":"2015-09-03","doc_url":"https://findmynpi.com/api"}}