{"npi":"1275827248","type":"NPI-1","status":"active","name":{"display":"Dr. Justin Ellett MD, PHD","other":[],"first":"JUSTIN","last":"ELLETT","middle":"DANIEL","credential":"MD, PHD"},"specialty":{"primary_taxonomy":"208800000X","primary_taxonomy_description":"Urology Physician","slug":"urology-physician","schema_org_specialty":null,"all":[{"code":"208800000X","description":"Urology Physician","primary":true,"state":"SC","license":"33598"}]},"addresses":[{"purpose":"LOCATION","street_1":"2687 LAKE PARK DRIVE","city":"N CHARLESTON","state":"SC","postal_code":"29406","country_code":"US","phone":"8435721010","fax":"8435691719"},{"purpose":"MAILING","street_1":"641 SAINT ANDREWS BLVD","city":"CHARLESTON","state":"SC","postal_code":"294077165","country_code":"US","phone":"8437664070","fax":"8437660633"}],"license":{"state":"SC","number":"33598"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"335989","state":"SC","issuer":null},{"type_code":"01","label":"Other","value":"1275827248","state":"SC","issuer":"MEDCOST"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20160620001115","type_code":"14-34","type_desc":"PRACTITIONER - UROLOGY","state":"SC","pac_id":"8527357318"}]},"enumeration_date":"2011-06-07","last_updated":"2017-02-17","_meta":{"source":"NPPES","snapshot_date":"2017-02-17","doc_url":"https://findmynpi.com/api"}}