{"npi":"1316299787","type":"NPI-2","status":"active","name":{"display":"Mount Eddy Emergency Physicians Medical Group, Inc.","other":[],"organization_name":"MOUNT EDDY EMERGENCY PHYSICIANS MEDICAL GROUP, INC.","authorised_official":"Steven Maron"},"specialty":{"primary_taxonomy":"207P00000X","primary_taxonomy_description":"Emergency Medicine","slug":"emergency-medicine","schema_org_specialty":"Emergency","all":[{"code":"207P00000X","description":"Emergency Medicine","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"914 PINE ST","city":"MOUNT SHASTA","state":"CA","postal_code":"960672143","country_code":"US","phone":"3304934443"},{"purpose":"MAILING","street_1":"4535 DRESSLER RD NW","city":"CANTON","state":"OH","postal_code":"447182545","country_code":"US","phone":"3304934443","fax":"3304938677"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"1316299787","state":"CA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20130118000029","type_code":"12-87","type_desc":"PART B SUPPLIER - OTHER","state":"CA","pac_id":"7416100714"}]},"enumeration_date":"2012-10-10","last_updated":"2021-06-24","_meta":{"source":"NPPES","snapshot_date":"2021-06-24","doc_url":"https://findmynpi.com/api"}}