{"npi":"1861449720","type":"NPI-2","status":"active","name":{"display":"Kornely Podiatry, LLC","other":[],"organization_name":"KORNELY PODIATRY, LLC","authorised_official":"Lisa Kornely"},"specialty":{"primary_taxonomy":"213E00000X","primary_taxonomy_description":"Podiatry","slug":"podiatry","schema_org_specialty":"Podiatric","all":[{"code":"332B00000X","description":"Durable Medical Equipment & Medical Supplies","primary":false,"state":null,"license":null},{"code":"213E00000X","description":"Podiatry","primary":true,"state":"WI","license":"774-025"}]},"addresses":[{"purpose":"LOCATION","street_1":"2358 W WASHINGTON ST","city":"WEST BEND","state":"WI","postal_code":"530952118","country_code":"US","phone":"2623352930","fax":"2623352931"},{"purpose":"MAILING","street_1":"2358 W WASHINGTON ST","city":"WEST BEND","state":"WI","postal_code":"530952118","country_code":"US","phone":"2623352930","fax":"2623352931"}],"license":{"state":"WI","number":"774-025"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"43225400","state":"WI","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20061214000331","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"WI","pac_id":"7719986009"},{"enrlmt_id":"O20100930035543","type_code":"30-48","type_desc":"DME SUPPLIER - PHYSICIAN - PODIATRY","state":"WI","pac_id":"7719986009"}]},"enumeration_date":"2006-05-27","last_updated":"2022-02-01","_meta":{"source":"NPPES","snapshot_date":"2022-02-01","doc_url":"https://findmynpi.com/api"}}