{"npi":"1407943673","type":"NPI-1","status":"active","name":{"display":"Glenn Green MD","other":[],"first":"GLENN","last":"GREEN","middle":"E","credential":"MD"},"specialty":{"primary_taxonomy":"207YP0228X","primary_taxonomy_description":"Pediatric Otolaryngology Physician","slug":"pediatric-otolaryngology-physician","schema_org_specialty":null,"all":[{"code":"207Y00000X","description":"Otolaryngology Physician","primary":false,"state":"MI","license":"4301057683"},{"code":"207YP0228X","description":"Pediatric Otolaryngology Physician","primary":true,"state":"MI","license":"4301057683"}]},"addresses":[{"purpose":"LOCATION","street_1":"1500 E MEDICAL CENTER DR","city":"ANN ARBOR","state":"MI","postal_code":"481095000","country_code":"US","phone":"7349364000"},{"purpose":"MAILING","street_1":"3621 S STATE ST","city":"ANN ARBOR","state":"MI","postal_code":"481081633","country_code":"US","phone":"7346475299"}],"license":{"state":"MI","number":"4301057683"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"4569350","state":"MI","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20040306000085","type_code":"14-04","type_desc":"PRACTITIONER - OTOLARYNGOLOGY","state":"MI","pac_id":"1557259116"}]},"enumeration_date":"2006-10-06","last_updated":"2019-11-25","_meta":{"source":"NPPES","snapshot_date":"2019-11-25","doc_url":"https://findmynpi.com/api"}}