{"npi":"1275868572","type":"NPI-1","status":"active","name":{"display":"Mr. Kenneth Miller PA-C","other":[],"first":"KENNETH","last":"MILLER","middle":"DOMINIQUE","credential":"PA-C"},"specialty":{"primary_taxonomy":"363AS0400X","primary_taxonomy_description":"Surgical Physician Assistant","slug":"surgical-physician-assistant","schema_org_specialty":null,"all":[{"code":"363AM0700X","description":"Medical Physician Assistant","primary":false,"state":"WA","license":"PA60115570"},{"code":"363A00000X","description":"Physician Assistant","primary":false,"state":"WA","license":"PA60115570"},{"code":"363AS0400X","description":"Surgical Physician Assistant","primary":true,"state":"WA","license":"PA60115570"}]},"addresses":[{"purpose":"LOCATION","street_1":"875 SWIFT BLVD","city":"RICHLAND","state":"WA","postal_code":"993523592","country_code":"US","phone":"5099461654","fax":"5099435652"},{"purpose":"MAILING","street_1":"560 GAGE BLVD","city":"RICHLAND","state":"WA","postal_code":"99352","country_code":"US","street_2":"SUITE 203","phone":"5099423627","fax":"5099422268"}],"license":{"state":"WA","number":"PA60115570"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"2004006","state":"WA","issuer":null},{"type_code":"01","label":"Other","value":"0255435","state":"WA","issuer":"LIWA VCR"},{"type_code":"01","label":"Other","value":"0016MI","state":"WA","issuer":"BSWA KADLEC"},{"type_code":"05","label":"Medicaid","value":"500619959","state":"OR","issuer":null},{"type_code":"05","label":"Medicaid","value":"808497500","state":"ID","issuer":null},{"type_code":"01","label":"Other","value":"P00781687","state":"WA","issuer":"RRGA"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20091110000322","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"WA","pac_id":"1850350950"}]},"enumeration_date":"2009-10-05","last_updated":"2017-01-23","_meta":{"source":"NPPES","snapshot_date":"2017-01-23","doc_url":"https://findmynpi.com/api"}}