{"npi":"1508556028","type":"NPI-1","status":"active","name":{"display":"John Deetjen PA-C","other":[],"first":"JOHN","last":"DEETJEN","middle":"DAVID","credential":"PA-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":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"1201 FAIRMOUNT AVE","city":"FORT WORTH","state":"TX","postal_code":"761044215","country_code":"US","phone":"8173355288","fax":"8173380927"},{"purpose":"MAILING","street_1":"6100 HARRIS PKWY STE 285","city":"FORT WORTH","state":"TX","postal_code":"761324127","country_code":"US","phone":"8172635864","fax":"8173946294"}],"license":null,"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20230725003005","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"TX","pac_id":"6204297146"}]},"enumeration_date":"2023-05-09","last_updated":"2023-05-09","_meta":{"source":"NPPES","snapshot_date":"2023-05-09","doc_url":"https://findmynpi.com/api"}}