{"npi":"1316978166","type":"NPI-1","status":"active","name":{"display":"Edgar Wollam","other":[{"code":"5","type":"Also known as","value":"WOLLAM, GARY"}],"first":"EDGAR","last":"WOLLAM"},"specialty":{"primary_taxonomy":"207RN0300X","primary_taxonomy_description":"Nephrology Physician","slug":"nephrology-physician","schema_org_specialty":null,"all":[{"code":"207RN0300X","description":"Nephrology Physician","primary":true,"state":"GA","license":"19436"}]},"addresses":[{"purpose":"LOCATION","street_1":"1660 MULKEY RD","city":"AUSTELL","state":"GA","postal_code":"30106","country_code":"US","street_2":"STE B","phone":"6784602700","fax":"7707390212"},{"purpose":"MAILING","street_1":"1660 MULKEY RD","city":"AUSTELL","state":"GA","postal_code":"30106","country_code":"US","street_2":"STE B","phone":"6784602700","fax":"7707390212"}],"license":{"state":"GA","number":"19436"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"000146187C","state":"GA","issuer":null},{"type_code":"01","label":"Other","value":"920632","state":"GA","issuer":"AETNA"},{"type_code":"05","label":"Medicaid","value":"000146187E","state":"GA","issuer":null},{"type_code":"05","label":"Medicaid","value":"0001416187H","state":"GA","issuer":null},{"type_code":"05","label":"Medicaid","value":"000146187F","state":"GA","issuer":null},{"type_code":"01","label":"Other","value":"110059639","state":"GA","issuer":"RR MEDICARE"},{"type_code":"05","label":"Medicaid","value":"000146187B","state":"GA","issuer":null},{"type_code":"05","label":"Medicaid","value":"000146187D","state":"GA","issuer":null},{"type_code":"01","label":"Other","value":"356860","state":"GA","issuer":"BCBS"},{"type_code":"01","label":"Other","value":"581992673003","state":"GA","issuer":"UHC"},{"type_code":"05","label":"Medicaid","value":"000146187G","state":"GA","issuer":null},{"type_code":"01","label":"Other","value":"03169","state":"GA","issuer":"BCBS GROUP #"}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-07-06","last_updated":"2011-10-19","_meta":{"source":"NPPES","snapshot_date":"2011-10-19","doc_url":"https://findmynpi.com/api"}}