{"npi":"1740200468","type":"NPI-1","status":"active","name":{"display":"Mrs. Kylisha Mallard Aa","other":[],"first":"KYLISHA","last":"MALLARD","middle":"J","credential":"AA"},"specialty":{"primary_taxonomy":"367H00000X","primary_taxonomy_description":"Anesthesiologist Assistant","slug":"anesthesiologist-assistant","schema_org_specialty":null,"all":[{"code":"363A00000X","description":"Physician Assistant","primary":false,"state":"GA","license":"0004593"},{"code":"367H00000X","description":"Anesthesiologist Assistant","primary":true,"state":"GA","license":"4593"}]},"addresses":[{"purpose":"LOCATION","street_1":"1968 PEACHTREE ROAD NW","city":"ATLANTA","state":"GA","postal_code":"303091281","country_code":"US","phone":"4043511745","fax":"4043517121"},{"purpose":"MAILING","street_1":"PO BOX 551420","city":"FORT LAUDERDALE","state":"FL","postal_code":"333551420","country_code":"US","phone":"8002433839","fax":"9548392569"}],"license":{"state":"GA","number":"4593"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"760751927C","state":"GA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20051107000532","type_code":"14-32","type_desc":"PRACTITIONER - ANESTHESIOLOGY ASSISTANT","state":"GA","pac_id":"9335167568"}]},"enumeration_date":"2006-07-19","last_updated":"2024-01-09","_meta":{"source":"NPPES","snapshot_date":"2024-01-09","doc_url":"https://findmynpi.com/api"}}