{"npi":"1386643310","type":"NPI-1","status":"active","name":{"display":"Dr. Ethan Wagner DO","other":[],"first":"ETHAN","last":"WAGNER","middle":"E","credential":"DO"},"specialty":{"primary_taxonomy":"207P00000X","primary_taxonomy_description":"Emergency Medicine","slug":"emergency-medicine","schema_org_specialty":"Emergency","all":[{"code":"207P00000X","description":"Emergency Medicine","primary":true,"state":"IN","license":"02002898A"}]},"addresses":[{"purpose":"LOCATION","street_1":"2015 JACKSON ST","city":"ANDERSON","state":"IN","postal_code":"460164337","country_code":"US","phone":"7656468439","fax":"7656468578"},{"purpose":"MAILING","street_1":"2015 JACKSON ST","city":"ANDERSON","state":"IN","postal_code":"460164337","country_code":"US","phone":"7656468439","fax":"7656468578"}],"license":{"state":"IN","number":"02002898A"},"identifiers":[{"type_code":"01","label":"Other","value":"000000514519","state":"IN","issuer":"BLUE CROSS /ANTHEM"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20050601000860","type_code":"14-93","type_desc":"PRACTITIONER - EMERGENCY MEDICINE","state":"IN","pac_id":"9234128240"}]},"enumeration_date":"2005-07-20","last_updated":"2007-10-10","_meta":{"source":"NPPES","snapshot_date":"2007-10-10","doc_url":"https://findmynpi.com/api"}}