{"npi":"1902303589","type":"NPI-1","status":"active","name":{"display":"Clayton Wagner","other":[],"first":"CLAYTON","last":"WAGNER","middle":"THOMAS"},"specialty":{"primary_taxonomy":"207Q00000X","primary_taxonomy_description":"Family Medicine","slug":"family-medicine","schema_org_specialty":"PrimaryCare","all":[{"code":"207Q00000X","description":"Family Medicine","primary":true,"state":"MN","license":"68745"}]},"addresses":[{"purpose":"LOCATION","street_1":"15350 ENGLISH AVE","city":"APPLE VALLEY","state":"MN","postal_code":"551246252","country_code":"US","phone":"9524318500"},{"purpose":"MAILING","street_1":"8170 33RD AVE S","city":"BLOOMINGTON","state":"MN","postal_code":"554254516","country_code":"US","street_2":"MS 21110Q"}],"license":{"state":"MN","number":"68745"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20210723001226","type_code":"14-08","type_desc":"PRACTITIONER - FAMILY PRACTICE","state":"MN","pac_id":"2860749439"},{"enrlmt_id":"I20240621001242","type_code":"14-08","type_desc":"PRACTITIONER - FAMILY PRACTICE","state":"WI","pac_id":"2860749439"}]},"enumeration_date":"2018-04-10","last_updated":"2024-10-04","_meta":{"source":"NPPES","snapshot_date":"2024-10-04","doc_url":"https://findmynpi.com/api"}}