{"npi":"1639673221","type":"NPI-1","status":"active","name":{"display":"Linda Phan MD","other":[],"first":"LINDA","last":"PHAN","middle":"KIM","credential":"MD"},"specialty":{"primary_taxonomy":"207RC0200X","primary_taxonomy_description":"Critical Care Medicine (Internal Medicine) Physician","slug":"critical-care-medicine-internal-medicine-physician","schema_org_specialty":null,"all":[{"code":"207RC0200X","description":"Critical Care Medicine (Internal Medicine) Physician","primary":true,"state":"IN","license":"01094355A"},{"code":"207R00000X","description":"Internal Medicine","primary":false,"state":"IN","license":"01094355A"},{"code":"207RP1001X","description":"Pulmonary Disease Physician","primary":false,"state":"IN","license":"01094355A"},{"code":"390200000X","description":"Student in an Organized Health Care Education/Training Program","primary":false,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"5165 MCCARTY LN","city":"LAFAYETTE","state":"IN","postal_code":"479058764","country_code":"US","phone":"7654488000","fax":"7658384758"},{"purpose":"MAILING","street_1":"2212 S 12TH ST","city":"TACOMA","state":"WA","postal_code":"984053026","country_code":"US"}],"license":{"state":"IN","number":"01094355A"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"300096078","state":"IN","issuer":null},{"type_code":"01","label":"Other","value":"815500692","state":"IN","issuer":"MEDICARE PTAN"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20230205000018","type_code":"14-11","type_desc":"PRACTITIONER - INTERNAL MEDICINE","state":"NY","pac_id":"7517201197"},{"enrlmt_id":"I20240912000894","type_code":"14-29","type_desc":"PRACTITIONER - PULMONARY DISEASE","state":"IN","pac_id":"7517201197"}]},"enumeration_date":"2018-03-20","last_updated":"2024-10-01","_meta":{"source":"NPPES","snapshot_date":"2024-10-01","doc_url":"https://findmynpi.com/api"}}