{"npi":"1497723217","type":"NPI-1","status":"active","name":{"display":"Kelly Landle P.A.-C","other":[],"first":"KELLY","last":"LANDLE","middle":"MARIE","credential":"P.A.-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":"ID","license":"PA-345"},{"code":"363AS0400X","description":"Surgical Physician Assistant","primary":false,"state":"WA","license":"PA10004069"},{"code":"363AM0700X","description":"Medical Physician Assistant","primary":false,"state":"WA","license":"PA10004069"}]},"addresses":[{"purpose":"LOCATION","street_1":"606 E MAIN ST","city":"KENDRICK","state":"ID","postal_code":"83537","country_code":"US","phone":"2082893841","fax":"2082893961"},{"purpose":"MAILING","street_1":"700 S MAIN ST","city":"MOSCOW","state":"ID","postal_code":"838433046","country_code":"US","phone":"2088824511"}],"license":{"state":"ID","number":"PA-345"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"806673600","state":"ID","issuer":null},{"type_code":"01","label":"Other","value":"970027265","state":null,"issuer":"RAILROAD MEDICARE"},{"type_code":"01","label":"Other","value":"0141613","state":"WA","issuer":"STATE WORK COMP"},{"type_code":"05","label":"Medicaid","value":"8201634","state":"WA","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-03-08","last_updated":"2019-04-16","_meta":{"source":"NPPES","snapshot_date":"2019-04-16","doc_url":"https://findmynpi.com/api"}}