{"npi":"1407855935","type":"NPI-2","status":"active","name":{"display":"Central Kentucky Interventional Pain Center, PLLC","other":[],"organization_name":"CENTRAL KENTUCKY INTERVENTIONAL PAIN CENTER, PLLC","authorised_official":"Khursheed Siddiqui"},"specialty":{"primary_taxonomy":"208VP0000X","primary_taxonomy_description":"Pain Medicine Physician","slug":"pain-medicine-physician","schema_org_specialty":null,"all":[{"code":"174400000X","description":"Specialist","primary":false,"state":"KY","license":"28741"},{"code":"207LP2900X","description":"Anesthesiology, Pain Medicine","primary":false,"state":null,"license":null},{"code":"208VP0014X","description":"Pain Medicine","primary":false,"state":null,"license":null},{"code":"208VP0000X","description":"Pain Medicine Physician","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"300 W BROADWAY ST","city":"DANVILLE","state":"KY","postal_code":"404221408","country_code":"US","phone":"8592360606","fax":"8592360066"},{"purpose":"MAILING","street_1":"PO BOX 7096","city":"STOCKTON","state":"CA","postal_code":"952670096","country_code":"US","phone":"2099567725","fax":"2099567733"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"65942906","state":"KY","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2005-07-18","last_updated":"2017-12-28","_meta":{"source":"NPPES","snapshot_date":"2017-12-28","doc_url":"https://findmynpi.com/api"}}