{"npi":"1326048935","type":"NPI-1","status":"active","name":{"display":"Dr. Charles Wetherington M.D.","other":[],"first":"CHARLES","last":"WETHERINGTON","middle":"A","credential":"M.D."},"specialty":{"primary_taxonomy":"207T00000X","primary_taxonomy_description":"Neurological Surgery Physician","slug":"neurological-surgery-physician","schema_org_specialty":null,"all":[{"code":"207T00000X","description":"Neurological Surgery Physician","primary":true,"state":"MO","license":"104062"}]},"addresses":[{"purpose":"LOCATION","street_1":"1055 BOWLES AVE STE 200","city":"FENTON","state":"MO","postal_code":"630262308","country_code":"US","phone":"6364963900"},{"purpose":"MAILING","street_1":"PO BOX 955534","city":"SAINT LOUIS","state":"MO","postal_code":"631955534","country_code":"US"}],"license":{"state":"MO","number":"104062"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"204694509","state":"MO","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20100806000728","type_code":"14-14","type_desc":"PRACTITIONER - NEUROSURGERY","state":"MO","pac_id":"8426181702"}]},"enumeration_date":"2005-07-26","last_updated":"2020-11-24","_meta":{"source":"NPPES","snapshot_date":"2020-11-24","doc_url":"https://findmynpi.com/api"}}