{"npi":"1962467977","type":"NPI-1","status":"active","name":{"display":"Laura Burgeson PA-C","other":[{"code":"1","type":"Formerly known as","value":"TRIPHAHN, LAURA K"}],"first":"LAURA","last":"BURGESON","middle":"K.","credential":"PA-C"},"specialty":{"primary_taxonomy":"363A00000X","primary_taxonomy_description":"Physician Assistant","slug":"physician-assistant","schema_org_specialty":null,"all":[{"code":"363A00000X","description":"Physician Assistant","primary":true,"state":"ID","license":"PA533"}]},"addresses":[{"purpose":"LOCATION","street_1":"1986 W HAYDEN AVE","city":"HAYDEN","state":"ID","postal_code":"838357412","country_code":"US","phone":"2087627760","fax":"2087627740"},{"purpose":"MAILING","street_1":"1986 W HAYDEN AVE","city":"HAYDEN","state":"ID","postal_code":"838357412","country_code":"US","phone":"2087627760","fax":"2087627740"}],"license":{"state":"ID","number":"PA533"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"807116700","state":"ID","issuer":null},{"type_code":"05","label":"Medicaid","value":"8421174","state":"WA","issuer":null},{"type_code":"01","label":"Other","value":"16666921","state":null,"issuer":"MEDICARE PTAN"},{"type_code":"05","label":"Medicaid","value":"7144785","state":"WA","issuer":null},{"type_code":"05","label":"Medicaid","value":"8080036","state":"ID","issuer":null},{"type_code":"01","label":"Other","value":"1370136","state":null,"issuer":"MEDICARE GROUP PTAN"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20050210000945","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"ID","pac_id":"7517919285"},{"enrlmt_id":"I20110524000661","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"WA","pac_id":"7517919285"}]},"enumeration_date":"2006-04-20","last_updated":"2021-06-16","_meta":{"source":"NPPES","snapshot_date":"2021-06-16","doc_url":"https://findmynpi.com/api"}}