{"npi":"1366539652","type":"NPI-1","status":"active","name":{"display":"Mrs. Suzanne Fernbach PA-C","other":[{"code":"1","type":"Formerly known as","value":"BIRD, SUZANNE M"}],"first":"SUZANNE","last":"FERNBACH","middle":"MICHELLE","credential":"PA-C"},"specialty":{"primary_taxonomy":"363A00000X","primary_taxonomy_description":"Physician Assistant","slug":"physician-assistant","schema_org_specialty":null,"all":[{"code":"363A00000X","description":"Physician Assistant","primary":false,"state":"IN","license":"10002914A"},{"code":"363AM0700X","description":"Medical Physician Assistant","primary":false,"state":"KY","license":"PA646"},{"code":"363A00000X","description":"Physician Assistant","primary":true,"state":"KY","license":"PA646"}]},"addresses":[{"purpose":"LOCATION","street_1":"405 VIOLET RD","city":"CRITTENDEN","state":"KY","postal_code":"410308956","country_code":"US","phone":"8599030268","fax":"8594281444"},{"purpose":"MAILING","street_1":"PO BOX 635283","city":"CINCINNATI","state":"OH","postal_code":"452635283","country_code":"US","phone":"8599030268","fax":"8894281444"}],"license":{"state":"KY","number":"PA646"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"95002804","state":"KY","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20090409000039","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"KY","pac_id":"5092610535"},{"enrlmt_id":"I20161129001608","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"OH","pac_id":"5092610535"}]},"enumeration_date":"2006-10-06","last_updated":"2022-08-26","_meta":{"source":"NPPES","snapshot_date":"2022-08-26","doc_url":"https://findmynpi.com/api"}}