{"npi":"1639726656","type":"NPI-1","status":"active","name":{"display":"Ashley Elleseg PA-C","other":[{"code":"1","type":"Formerly known as","value":"GAVIGAN, ASHLEY V"}],"first":"ASHLEY","last":"ELLESEG","middle":"V","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":false,"state":null,"license":"1173669"},{"code":"363A00000X","description":"Physician Assistant","primary":false,"state":null,"license":null},{"code":"363A00000X","description":"Physician Assistant","primary":true,"state":"WI","license":"5081"}]},"addresses":[{"purpose":"LOCATION","street_1":"N84W16889 MENOMONEE AVE","city":"MENOMONEE FALLS","state":"WI","postal_code":"530512810","country_code":"US","phone":"2622517500"},{"purpose":"MAILING","street_1":"PO BOX 735044","city":"CHICAGO","state":"IL","postal_code":"606732843","country_code":"US"}],"license":{"state":"WI","number":"5081"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"100138733","state":"WI","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20201215003123","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"WI","pac_id":"7416369475"}]},"enumeration_date":"2019-08-23","last_updated":"2023-09-22","_meta":{"source":"NPPES","snapshot_date":"2023-09-22","doc_url":"https://findmynpi.com/api"}}