{"npi":"1790798593","type":"NPI-1","status":"active","name":{"display":"Dr. Larry Wellendorf MD","other":[],"first":"LARRY","last":"WELLENDORF","middle":"L","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":false,"state":"IL","license":"036091551"},{"code":"207Q00000X","description":"Family Medicine","primary":true,"state":"ID","license":"MC-2626"}]},"addresses":[{"purpose":"LOCATION","street_1":"2236 N MERRITT CREEK LOOP STE A","city":"COEUR D ALENE","state":"ID","postal_code":"838144960","country_code":"US","phone":"2086253670","fax":"2086253675"},{"purpose":"MAILING","street_1":"2003 KOOTENAI HEALTH WAY","city":"COEUR D ALENE","state":"ID","postal_code":"838146051","country_code":"US","phone":"2086255084"}],"license":{"state":"ID","number":"MC-2626"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"036091551","state":"IL","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20031217000093","type_code":"14-08","type_desc":"PRACTITIONER - FAMILY PRACTICE","state":"IL","pac_id":"8325945496"},{"enrlmt_id":"I20240327003369","type_code":"14-08","type_desc":"PRACTITIONER - FAMILY PRACTICE","state":"ID","pac_id":"8325945496"}]},"enumeration_date":"2006-08-14","last_updated":"2025-07-25","_meta":{"source":"NPPES","snapshot_date":"2025-07-25","doc_url":"https://findmynpi.com/api"}}