{"npi":"1619977295","type":"NPI-2","status":"active","name":{"display":"Wyrick Dermatology Association","other":[],"organization_name":"WYRICK DERMATOLOGY ASSOCIATION","authorised_official":"Scott Wyrick"},"specialty":{"primary_taxonomy":"261Q00000X","primary_taxonomy_description":"Clinic/Center","slug":"clinic-center","schema_org_specialty":null,"all":[{"code":"261Q00000X","description":"Clinic/Center","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"3333 POTOMAC AVE","city":"TEXARKANA","state":"TX","postal_code":"755033513","country_code":"US","phone":"9037923787","fax":"9037920446"},{"purpose":"MAILING","street_1":"3333 POTOMAC AVE","city":"TEXARKANA","state":"TX","postal_code":"755033513","country_code":"US","phone":"9037923787","fax":"9037920446"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"109371802","state":"TX","issuer":null},{"type_code":"05","label":"Medicaid","value":"145002002","state":"AR","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20110105000871","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"TX","pac_id":"5092904136"}]},"enumeration_date":"2005-07-26","last_updated":"2013-04-09","_meta":{"source":"NPPES","snapshot_date":"2013-04-09","doc_url":"https://findmynpi.com/api"}}