{"npi":"1871979393","type":"NPI-2","status":"active","name":{"display":"J. Kelly Theisen, D.D.S.","other":[],"organization_name":"J. KELLY THEISEN, D.D.S.","authorised_official":"John Theisen"},"specialty":{"primary_taxonomy":"122300000X","primary_taxonomy_description":"Dentist","slug":"dentist","schema_org_specialty":null,"all":[{"code":"122300000X","description":"Dentist","primary":true,"state":"CO","license":"DEN00106339"}]},"addresses":[{"purpose":"LOCATION","street_1":"521 E RAILROAD AVENUE","city":"FORT MORGAN","state":"CO","postal_code":"807013331","country_code":"US","phone":"9708672256","fax":"9705429464"},{"purpose":"MAILING","street_1":"521 E RAILROAD AVENUE","city":"FORT MORGAN","state":"CO","postal_code":"807013331","country_code":"US","phone":"9708672256","fax":"9705429464"}],"license":{"state":"CO","number":"DEN00106339"},"identifiers":[],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2015-08-06","last_updated":"2015-08-06","_meta":{"source":"NPPES","snapshot_date":"2015-08-06","doc_url":"https://findmynpi.com/api"}}