{"result_count":1,"results":[{"addresses":[{"address_1":"550 MUNSON AVE","address_2":"SUITE 200","address_purpose":"MAILING","address_type":"DOM","city":"TRAVERSE CITY","country_code":"US","country_name":"United States","fax_number":"231-935-9230","postal_code":"496863580","state":"MI","telephone_number":"231-935-8717"},{"address_1":"550 MUNSON AVE","address_2":"SUITE 200","address_purpose":"LOCATION","address_type":"DOM","city":"TRAVERSE CITY","country_code":"US","country_name":"United States","fax_number":"231-935-9230","postal_code":"496863580","state":"MI","telephone_number":"231-935-8717"}],"basic":{"authorized_official_credential":"MHA","authorized_official_first_name":"SOUMIT","authorized_official_last_name":"PENDHARKAR","authorized_official_middle_name":"SHAM","authorized_official_name_prefix":"--","authorized_official_name_suffix":"--","authorized_official_telephone_number":"2319358717","authorized_official_title_or_position":"Office Manager","enumeration_date":"2007-05-17","last_updated":"2020-08-22","organization_name":"NORTHWESTERN MICHIGAN DERMATOLOGY","organizational_subpart":"NO","status":"A"},"created_epoch":"1179427148000","endpoints":[],"enumeration_type":"NPI-2","identifiers":[{"code":"01","desc":"Other (non-Medicare)","identifier":"1285743393","issuer":"NPI","state":"MI"},{"code":"01","desc":"Other (non-Medicare)","identifier":"1437268661","issuer":"NPI","state":"MI"},{"code":"01","desc":"Other (non-Medicare)","identifier":"1770692873","issuer":"NPI Number","state":"MI"},{"code":"01","desc":"Other (non-Medicare)","identifier":"1962511097","issuer":"NPI","state":"MI"},{"code":"05","desc":"MEDICAID","identifier":"1997138","issuer":null,"state":"MI"},{"code":"05","desc":"MEDICAID","identifier":"3347473","issuer":null,"state":"MI"},{"code":"01","desc":"Other (non-Medicare)","identifier":"4301063462","issuer":"MI License","state":"MI"},{"code":"01","desc":"Other (non-Medicare)","identifier":"4301067697","issuer":"MI License","state":"MI"},{"code":"01","desc":"Other (non-Medicare)","identifier":"4301077553","issuer":"MI License","state":"MI"},{"code":"01","desc":"Other (non-Medicare)","identifier":"4301406284","issuer":"Michigan License","state":"MI"},{"code":"05","desc":"MEDICAID","identifier":"4317989","issuer":null,"state":"MI"}],"last_updated_epoch":"1598100723000","number":"1346457488","other_names":[],"practiceLocations":[],"taxonomies":[{"code":"207ND0101X","desc":"Dermatology, MOHS-Micrographic Surgery","license":null,"primary":true,"state":null,"taxonomy_group":"193400000X - Single Specialty Group"}]}]}