{"npi":"1972859403","type":"NPI-1","status":"active","name":{"display":"Mr. Cody Lewis PA-C","other":[],"first":"CODY","last":"LEWIS","middle":"W","credential":"PA-C"},"specialty":{"primary_taxonomy":"363AM0700X","primary_taxonomy_description":"Medical Physician Assistant","slug":"medical-physician-assistant","schema_org_specialty":null,"all":[{"code":"363AM0700X","description":"Medical Physician Assistant","primary":false,"state":"WA","license":"PA60796883"},{"code":"363AM0700X","description":"Medical Physician Assistant","primary":true,"state":"NM","license":"PA2012-0021"}]},"addresses":[{"purpose":"LOCATION","street_1":"2300 E 30TH ST BLDG D STE 101","city":"FARMINGTON","state":"NM","postal_code":"87401","country_code":"US","phone":"5053271400","fax":"5055643202"},{"purpose":"MAILING","street_1":"2300 E 30TH ST BLDG D STE 101","city":"FARMINGTON","state":"NM","postal_code":"87401","country_code":"US","phone":"5053271400","fax":"5055643202"}],"license":{"state":"NM","number":"PA2012-0021"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"58372539","state":"NM","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20120816000859","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"NM","pac_id":"4789830191"},{"enrlmt_id":"I20181105000428","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"TX","pac_id":"4789830191"},{"enrlmt_id":"I20240715004172","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"CO","pac_id":"4789830191"}]},"enumeration_date":"2012-08-02","last_updated":"2021-01-18","_meta":{"source":"NPPES","snapshot_date":"2021-01-18","doc_url":"https://findmynpi.com/api"}}