{"npi":"1639638984","type":"NPI-1","status":"active","name":{"display":"Nicholas Lacey Pt, Dpt","other":[],"first":"NICHOLAS","last":"LACEY","middle":"DAVID","credential":"PT, DPT"},"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":"CA","license":"296330"}]},"addresses":[{"purpose":"LOCATION","street_1":"1510 W BRANCH ST","city":"ARROYO GRANDE","state":"CA","postal_code":"934201817","country_code":"US","phone":"8054897912","fax":"8054899697"},{"purpose":"MAILING","street_1":"408 HIGUERA ST STE 200","city":"SAN LUIS OBISPO","state":"CA","postal_code":"934016135","country_code":"US","phone":"8057880805","fax":"8057880845"}],"license":{"state":"CA","number":"296330"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"14366874","state":"CA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20190919002509","type_code":"14-65","type_desc":"PRACTITIONER - PHYSICAL THERAPIST IN PRIVATE PRACTICE","state":"CA","pac_id":"6507196466"}]},"enumeration_date":"2019-03-17","last_updated":"2024-03-11","_meta":{"source":"NPPES","snapshot_date":"2024-03-11","doc_url":"https://findmynpi.com/api"}}