{"npi":"1144800905","type":"NPI-1","status":"active","name":{"display":"Kellan Klubben MD","other":[],"first":"KELLAN","last":"KLUBBEN","middle":"BRETT","credential":"MD"},"specialty":{"primary_taxonomy":"207Q00000X","primary_taxonomy_description":"Family Medicine","slug":"family-medicine","schema_org_specialty":"PrimaryCare","all":[{"code":"390200000X","description":"Student in an Organized Health Care Education/Training Program","primary":false,"state":null,"license":null},{"code":"207Q00000X","description":"Family Medicine","primary":true,"state":"WI","license":"84153-20"}]},"addresses":[{"purpose":"LOCATION","street_1":"11040 N STATE RD 77","city":"HAYWARD","state":"WI","postal_code":"54843","country_code":"US","phone":"7159344910"},{"purpose":"MAILING","street_1":"11040 N STATE RD 77","city":"HAYWARD","state":"WI","postal_code":"54843","country_code":"US","phone":"7159344910"}],"license":{"state":"WI","number":"84153-20"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20241114002529","type_code":"14-08","type_desc":"PRACTITIONER - FAMILY PRACTICE","state":"WI","pac_id":"0143754010"}]},"enumeration_date":"2021-04-14","last_updated":"2024-09-11","_meta":{"source":"NPPES","snapshot_date":"2024-09-11","doc_url":"https://findmynpi.com/api"}}