{"npi":"1295906675","type":"NPI-1","status":"active","name":{"display":"Bradley Boettcher CRNA","other":[],"first":"BRADLEY","last":"BOETTCHER","middle":"J","credential":"CRNA"},"specialty":{"primary_taxonomy":"367500000X","primary_taxonomy_description":"Certified Registered Nurse Anesthetist","slug":"certified-registered-nurse-anesthetist","schema_org_specialty":null,"all":[{"code":"367500000X","description":"Certified Registered Nurse Anesthetist","primary":true,"state":"WI","license":"3411"},{"code":"163W00000X","description":"Registered Nurse","primary":false,"state":"WI","license":"141347"}]},"addresses":[{"purpose":"LOCATION","street_1":"744 S WEBSTER AVE","city":"GREEN BAY","state":"WI","postal_code":"543013505","country_code":"US","phone":"9204457222","fax":"9204457289"},{"purpose":"MAILING","street_1":"744 S WEBSTER AVE","city":"GREEN BAY","state":"WI","postal_code":"543013505","country_code":"US","phone":"9204457222","fax":"9204457289"}],"license":{"state":"WI","number":"3411"},"identifiers":[{"type_code":"01","label":"Other","value":"141347","state":"WI","issuer":"RN SECONDARY WI STATE LICENSE"},{"type_code":"01","label":"Other","value":"3411","state":"WI","issuer":"WI STATE LICENSE"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20080606000187","type_code":"14-43","type_desc":"PRACTITIONER - CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)","state":"WI","pac_id":"9830269588"}]},"enumeration_date":"2008-03-13","last_updated":"2018-11-01","_meta":{"source":"NPPES","snapshot_date":"2018-11-01","doc_url":"https://findmynpi.com/api"}}