{"npi":"1790797728","type":"NPI-2","status":"active","name":{"display":"Tallahassee Ear, Nose & Throat-Head & Neck Surgery, P.A.","other":[],"organization_name":"TALLAHASSEE EAR, NOSE & THROAT-HEAD & NECK SURGERY, P.A.","authorised_official":"Kim Quackenbush"},"specialty":{"primary_taxonomy":"207Y00000X","primary_taxonomy_description":"Otolaryngology Physician","slug":"otolaryngology-physician","schema_org_specialty":null,"all":[{"code":"207Y00000X","description":"Otolaryngology Physician","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"1405 CENTERVILLE RD","city":"TALLAHASSEE","state":"FL","postal_code":"323084655","country_code":"US","street_2":"SUITE 5400","phone":"8508770101","fax":"8508772750"},{"purpose":"MAILING","street_1":"1405 CENTERVILLE ROAD","city":"TALLAHASSEE","state":"FL","postal_code":"323084629","country_code":"US","street_2":"SUITE 5400","phone":"8508770101","fax":"8508772750"}],"license":null,"identifiers":[{"type_code":"01","label":"Other","value":"33294","state":"FL","issuer":"BCBS GROUP PROVIDER NUMBE"},{"type_code":"05","label":"Medicaid","value":"054317900","state":"FL","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20040602001104","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"FL","pac_id":"6608858840"}]},"enumeration_date":"2006-08-11","last_updated":"2011-08-12","_meta":{"source":"NPPES","snapshot_date":"2011-08-12","doc_url":"https://findmynpi.com/api"}}