{"npi":"1780919829","type":"NPI-1","status":"active","name":{"display":"Dr. Gordon Bontrager MD","other":[],"first":"GORDON","last":"BONTRAGER","middle":"SCOTT","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":"ID","license":"MRM-1734"},{"code":"363A00000X","description":"Physician Assistant","primary":false,"state":"TN","license":"2119"}]},"addresses":[{"purpose":"LOCATION","street_1":"43 N 1ST E","city":"PRESTON","state":"ID","postal_code":"832631325","country_code":"US","phone":"2086484771","fax":"2087440140"},{"purpose":"MAILING","street_1":"43 N 1ST E","city":"PRESTON","state":"ID","postal_code":"832631325","country_code":"US","phone":"2086484771","fax":"2087440140"}],"license":{"state":"ID","number":"MRM-1734"},"identifiers":[{"type_code":"01","label":"Other","value":"P01478459","state":"TN","issuer":"RAIDROAD MEDICARE"},{"type_code":"05","label":"Medicaid","value":"15285357","state":"TN","issuer":null},{"type_code":"01","label":"Other","value":"MRM-1734","state":"ID","issuer":"IDAHO BOARD OF MEDICINE - RESIDENCY"},{"type_code":"05","label":"Medicaid","value":"1780919829","state":"VA","issuer":null},{"type_code":"01","label":"Other","value":"PA-2119","state":"ID","issuer":"IDAHO BOARD OF MEDICINE - PA"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20201211001838","type_code":"14-08","type_desc":"PRACTITIONER - FAMILY PRACTICE","state":"ID","pac_id":"4486792769"}]},"enumeration_date":"2009-10-07","last_updated":"2025-01-29","_meta":{"source":"NPPES","snapshot_date":"2025-01-29","doc_url":"https://findmynpi.com/api"}}