{"npi":"1679551071","type":"NPI-1","status":"active","name":{"display":"Eileen Doherty Fuller MD","other":[],"first":"EILEEN","last":"DOHERTY FULLER","credential":"MD"},"specialty":{"primary_taxonomy":"207Q00000X","primary_taxonomy_description":"Family Medicine","slug":"family-medicine","schema_org_specialty":"PrimaryCare","all":[{"code":"207Q00000X","description":"Family Medicine","primary":true,"state":"VT","license":"042-007267"}]},"addresses":[{"purpose":"LOCATION","street_1":"1330 EXCHANGE ST STE 201","city":"MIDDLEBURY","state":"VT","postal_code":"057534464","country_code":"US","phone":"8023881500","fax":"8023880441"},{"purpose":"MAILING","street_1":"1330 EXCHANGE ST STE 201","city":"MIDDLEBURY","state":"VT","postal_code":"057534464","country_code":"US","phone":"8023881500","fax":"8023880441"}],"license":{"state":"VT","number":"042-007267"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"0005628","state":"VT","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20071130000158","type_code":"14-08","type_desc":"PRACTITIONER - FAMILY PRACTICE","state":"VT","pac_id":"2466462627"}]},"enumeration_date":"2006-01-05","last_updated":"2020-10-14","_meta":{"source":"NPPES","snapshot_date":"2020-10-14","doc_url":"https://findmynpi.com/api"}}