{"npi":"1376384909","type":"NPI-2","status":"active","name":{"display":"Clark Infusion Group LLC","other":[],"organization_name":"CLARK INFUSION GROUP LLC","authorised_official":"Kelsey Ruth"},"specialty":{"primary_taxonomy":"261QI0500X","primary_taxonomy_description":"Infusion Therapy Clinic/Center","slug":"infusion-therapy-clinic-center","schema_org_specialty":null,"all":[{"code":"261QI0500X","description":"Infusion Therapy Clinic/Center","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"124 PROFESSIONAL AVE","city":"WINCHESTER","state":"KY","postal_code":"403911116","country_code":"US","phone":"8595821730"},{"purpose":"MAILING","street_1":"136 LANA LN","city":"WINCHESTER","state":"KY","postal_code":"403912386","country_code":"US","phone":"8595821730"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"1811344211","state":"KY","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20241029002171","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"KY","pac_id":"1456884402"}]},"enumeration_date":"2024-06-06","last_updated":"2024-08-01","_meta":{"source":"NPPES","snapshot_date":"2024-08-01","doc_url":"https://findmynpi.com/api"}}