{"npi":"1366969578","type":"NPI-1","status":"active","name":{"display":"Ms. Lisa Shallenberger Mms, PA-C","other":[],"first":"LISA","last":"SHALLENBERGER","middle":"MARIE","credential":"MMS, 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":true,"state":"FL","license":"PA9110578"}]},"addresses":[{"purpose":"LOCATION","street_1":"4106 W LAKE MARY BLVD STE 205","city":"LAKE MARY","state":"FL","postal_code":"327463344","country_code":"US","phone":"4078515121"},{"purpose":"MAILING","street_1":"859 SILVERADO CT","city":"LAKE MARY","state":"FL","postal_code":"327464966","country_code":"US","phone":"7863012626"}],"license":{"state":"FL","number":"PA9110578"},"identifiers":[{"type_code":"01","label":"Other","value":"PA9110578","state":"FL","issuer":"LICENSE"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20231009003534","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"FL","pac_id":"9931554094"}]},"enumeration_date":"2017-08-28","last_updated":"2024-07-03","_meta":{"source":"NPPES","snapshot_date":"2024-07-03","doc_url":"https://findmynpi.com/api"}}