{"result_count":1,"results":[{"addresses":[{"address_1":"2323 W PIONEER PKWY","address_purpose":"MAILING","address_type":"DOM","city":"PEORIA","country_code":"US","country_name":"United States","fax_number":"309-691-4807","postal_code":"616151833","state":"IL","telephone_number":"309-691-4682"},{"address_1":"2323 W PIONEER PKWY","address_purpose":"LOCATION","address_type":"DOM","city":"PEORIA","country_code":"US","country_name":"United States","fax_number":"309-691-4807","postal_code":"616151833","state":"IL","telephone_number":"309-691-4682"}],"basic":{"authorized_official_credential":"RPh","authorized_official_first_name":"MICHAEL","authorized_official_last_name":"BETTIGA","authorized_official_middle_name":"J","authorized_official_name_prefix":"Mr.","authorized_official_name_suffix":"--","authorized_official_telephone_number":"9204294297","authorized_official_title_or_position":"Sr. Vice President Health Services","enumeration_date":"2006-06-24","last_updated":"2025-09-11","organization_name":"SHOPKO STORES OPERATING CO. LLC","organizational_subpart":"NO","status":"A"},"created_epoch":"1151124154000","endpoints":[],"enumeration_type":"NPI-2","identifiers":[{"code":"01","desc":"Other (non-Medicare)","identifier":"1473014","issuer":"NCPDP Number","state":null},{"code":"05","desc":"MEDICAID","identifier":"410985054174","issuer":null,"state":"IL"}],"last_updated_epoch":"1757623222000","number":"1538195300","other_names":[{"code":"3","organization_name":"SHOPKO PHARMACY 174","type":"Doing Business As"}],"practiceLocations":[],"taxonomies":[{"code":"3336C0003X","desc":"Pharmacy, Community/Retail Pharmacy","license":null,"primary":false,"state":"IL","taxonomy_group":""},{"code":"332B00000X","desc":"Durable Medical Equipment & Medical Supplies","license":null,"primary":true,"state":null,"taxonomy_group":""}]}]}