{"npi":"1871587253","type":"NPI-1","status":"active","name":{"display":"Dr. Shelley Sandbulte EDD","other":[{"code":"1","type":"Formerly known as","value":"PEDERSON, SHELLEY L"}],"first":"SHELLEY","last":"SANDBULTE","middle":"LYNN","credential":"EDD"},"specialty":{"primary_taxonomy":"103T00000X","primary_taxonomy_description":"Psychologist","slug":"psychologist","schema_org_specialty":null,"all":[{"code":"103T00000X","description":"Psychologist","primary":true,"state":"SD","license":"311"}]},"addresses":[{"purpose":"LOCATION","street_1":"2210 S BROWN PL","city":"SIOUX FALLS","state":"SD","postal_code":"571056582","country_code":"US","phone":"6053321700","fax":"6053369031"},{"purpose":"MAILING","street_1":"2210 S BROWN PL","city":"SIOUX FALLS","state":"SD","postal_code":"571056582","country_code":"US","phone":"6053321700","fax":"6053369031"}],"license":{"state":"SD","number":"311"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"6550683","state":"SD","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20060412000388","type_code":"14-68","type_desc":"PRACTITIONER - CLINICAL PSYCHOLOGIST","state":"SD","pac_id":"0749299105"}]},"enumeration_date":"2005-08-31","last_updated":"2012-03-05","_meta":{"source":"NPPES","snapshot_date":"2012-03-05","doc_url":"https://findmynpi.com/api"}}