{"npi":"1639921612","type":"NPI-1","status":"active","name":{"display":"Grayson Coulombe DPM","other":[],"first":"GRAYSON","last":"COULOMBE","middle":"ELISE","credential":"DPM"},"specialty":{"primary_taxonomy":"390200000X","primary_taxonomy_description":"Student in an Organized Health Care Education/Training Program","slug":"student-in-an-organized-health-care-education-training-program","schema_org_specialty":null,"all":[{"code":"390200000X","description":"Student in an Organized Health Care Education/Training Program","primary":true,"state":"IN","license":"41000490A"},{"code":"390200000X","description":"Student in an Organized Health Care Education/Training Program","primary":false,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"10122 E 10TH ST STE 230","city":"INDIANAPOLIS","state":"IN","postal_code":"462292664","country_code":"US","phone":"3173557356"},{"purpose":"MAILING","street_1":"10122 E 10TH ST STE 230","city":"INDIANAPOLIS","state":"IN","postal_code":"462292664","country_code":"US","phone":"3173557356"}],"license":{"state":"IN","number":"41000490A"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"300091942","state":"IN","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20240627001315","type_code":"33-48","type_desc":"ORDER AND REFERRING ONLY - PODIATRY","state":"IN","pac_id":"0547704827"}]},"enumeration_date":"2024-04-03","last_updated":"2024-06-20","_meta":{"source":"NPPES","snapshot_date":"2024-06-20","doc_url":"https://findmynpi.com/api"}}