{"npi":"1316346752","type":"NPI-1","status":"active","name":{"display":"Elizabeth Carlson PA-C","other":[{"code":"1","type":"Formerly known as","value":"BARNES, ELIZABETH M"}],"first":"ELIZABETH","last":"CARLSON","middle":"M","credential":"PA-C"},"specialty":{"primary_taxonomy":"363AS0400X","primary_taxonomy_description":"Surgical Physician Assistant","slug":"surgical-physician-assistant","schema_org_specialty":null,"all":[{"code":"363A00000X","description":"Physician Assistant","primary":false,"state":"WI","license":"3404"},{"code":"363AS0400X","description":"Surgical Physician Assistant","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"235 WEALTHY ST SE","city":"GRAND RAPIDS","state":"MI","postal_code":"495035247","country_code":"US","phone":"6168408224","fax":"6168409690"},{"purpose":"MAILING","street_1":"235 WEALTHY ST SE","city":"GRAND RAPIDS","state":"MI","postal_code":"495035247","country_code":"US","phone":"6168408224","fax":"6168409690"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"1316346752","state":"MI","issuer":null},{"type_code":"01","label":"Other","value":"EB007542","state":"MI","issuer":"BCBS"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20151001000099","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"MI","pac_id":"8527289107"}]},"enumeration_date":"2014-08-21","last_updated":"2026-05-28","_meta":{"source":"NPPES","snapshot_date":"2026-05-28","doc_url":"https://findmynpi.com/api"}}