{"npi":"1629073135","type":"NPI-1","status":"active","name":{"display":"Mr. Philip Bergold Pt","other":[],"first":"PHILIP","last":"BERGOLD","middle":"WILLIAM","credential":"PT"},"specialty":{"primary_taxonomy":"225100000X","primary_taxonomy_description":"Physical Therapist","slug":"physical-therapist","schema_org_specialty":null,"all":[{"code":"225100000X","description":"Physical Therapist","primary":true,"state":"WI","license":"5058"}]},"addresses":[{"purpose":"LOCATION","street_1":"5889 RIVERSIDE DR","city":"GREENDALE","state":"WI","postal_code":"531292817","country_code":"US","phone":"4149407278","fax":"4142358448"},{"purpose":"MAILING","street_1":"PO BOX 370081","city":"MILWAUKEE","state":"WI","postal_code":"532371181","country_code":"US","phone":"4149407278","fax":"4142358448"}],"license":{"state":"WI","number":"5058"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"40377300","state":"WI","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20031120000925","type_code":"14-65","type_desc":"PRACTITIONER - PHYSICAL THERAPIST IN PRIVATE PRACTICE","state":"WI","pac_id":"2365346483"}]},"enumeration_date":"2005-06-21","last_updated":"2016-02-07","_meta":{"source":"NPPES","snapshot_date":"2016-02-07","doc_url":"https://findmynpi.com/api"}}