{"npi":"1760043046","type":"NPI-2","status":"active","name":{"display":"Skin In The Game, PLLC","other":[],"organization_name":"SKIN IN THE GAME, PLLC","authorised_official":"Holly Harlan"},"specialty":{"primary_taxonomy":"207N00000X","primary_taxonomy_description":"Dermatology","slug":"dermatology","schema_org_specialty":"Dermatologic","all":[{"code":"207N00000X","description":"Dermatology","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"6510 HIGHWAY 90","city":"GAUTIER","state":"MS","postal_code":"395535015","country_code":"US","phone":"2288643300","fax":"2288643333"},{"purpose":"MAILING","street_1":"PO BOX 6625","city":"GULFPORT","state":"MS","postal_code":"395066625","country_code":"US","phone":"2288643300","fax":"2288643333"}],"license":null,"identifiers":[{"type_code":"01","label":"Other","value":"909605","state":"MS","issuer":"MEDICARE"},{"type_code":"05","label":"Medicaid","value":"09474302","state":"MS","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20200131001267","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"MS","pac_id":"8022444538"}]},"enumeration_date":"2019-06-26","last_updated":"2023-02-24","_meta":{"source":"NPPES","snapshot_date":"2023-02-24","doc_url":"https://findmynpi.com/api"}}