{"npi":"1871798538","type":"NPI-1","status":"active","name":{"display":"Dr. Clarissa Diamantidis M.D.","other":[{"code":"1","type":"Formerly known as","value":"JONAS, CLARISSA MARIA"}],"first":"CLARISSA","last":"DIAMANTIDIS","middle":"JONAS","credential":"M.D."},"specialty":{"primary_taxonomy":"207R00000X","primary_taxonomy_description":"Internal Medicine","slug":"internal-medicine","schema_org_specialty":"Internal","all":[{"code":"207RN0300X","description":"Nephrology Physician","primary":false,"state":"MD","license":"D70807"},{"code":"207R00000X","description":"Internal Medicine","primary":true,"state":"NC","license":"2014-01223"}]},"addresses":[{"purpose":"LOCATION","street_1":"MEDICAL CENTER BLVD","city":"WINSTON SALEM","state":"NC","postal_code":"271571544","country_code":"US","phone":"3367134156","fax":"3367164359"},{"purpose":"MAILING","street_1":"MEDICAL CENTER BLVD","city":"WINSTON SALEM","state":"NC","postal_code":"271570001","country_code":"US","phone":"3367134156","fax":"3367167359"}],"license":{"state":"NC","number":"2014-01223"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"510360600","state":"MD","issuer":null},{"type_code":"01","label":"Other","value":"965568-01 & 02","state":"MD","issuer":"CAREFIRST BC/BS"},{"type_code":"01","label":"Other","value":"S062-0394","state":"MD","issuer":"CAREFIRST BC/BS REGIONAL"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20240610003151","type_code":"14-11","type_desc":"PRACTITIONER - INTERNAL MEDICINE","state":"NC","pac_id":"4789716648"}]},"enumeration_date":"2007-06-20","last_updated":"2024-03-13","_meta":{"source":"NPPES","snapshot_date":"2024-03-13","doc_url":"https://findmynpi.com/api"}}