{"npi":"1346741501","type":"NPI-2","status":"active","name":{"display":"Coraesthetics PLLC","other":[],"organization_name":"CORAESTHETICS PLLC","authorised_official":"Jamie Coracides"},"specialty":{"primary_taxonomy":"363AS0400X","primary_taxonomy_description":"Surgical Physician Assistant","slug":"surgical-physician-assistant","schema_org_specialty":null,"all":[{"code":"363AS0400X","description":"Surgical Physician Assistant","primary":true,"state":"AZ","license":"4462"}]},"addresses":[{"purpose":"LOCATION","street_1":"2008 E LAGUNA DR","city":"TEMPE","state":"AZ","postal_code":"85282","country_code":"US","phone":"4803073497"},{"purpose":"MAILING","street_1":"2008 E LAGUNA DR","city":"TEMPE","state":"AZ","postal_code":"852825915","country_code":"US"}],"license":{"state":"AZ","number":"4462"},"identifiers":[{"type_code":"01","label":"Other","value":"4462","state":"AZ","issuer":"PHYSICIAN ASSISTANT LICENCE"}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2018-02-23","last_updated":"2018-07-09","_meta":{"source":"NPPES","snapshot_date":"2018-07-09","doc_url":"https://findmynpi.com/api"}}