{"npi":"1265775993","type":"NPI-1","status":"active","name":{"display":"Dr. Jason Prudom M.D.","other":[],"first":"JASON","last":"PRUDOM","middle":"SCOTT","credential":"M.D."},"specialty":{"primary_taxonomy":"207RP1001X","primary_taxonomy_description":"Pulmonary Disease Physician","slug":"pulmonary-disease-physician","schema_org_specialty":null,"all":[{"code":"207RC0200X","description":"Critical Care Medicine (Internal Medicine) Physician","primary":false,"state":"WI","license":"63600-20"},{"code":"207RP1001X","description":"Pulmonary Disease Physician","primary":true,"state":"WI","license":"63600-20"}]},"addresses":[{"purpose":"LOCATION","street_1":"3201 S 16TH ST STE 2015","city":"MILWAUKEE","state":"WI","postal_code":"532154532","country_code":"US","phone":"4146493810","fax":"2622400841"},{"purpose":"MAILING","street_1":"GREATER MILWAUKEE CRITICAL CARE AND PULMONARY ASSOCIATE","city":"MILWAUKEE","state":"WI","postal_code":"532070520","country_code":"US","street_2":"PO BOX 070520","phone":"4146493810","fax":"2622400841"}],"license":{"state":"WI","number":"63600-20"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"100042547","state":"WI","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20190709000003","type_code":"14-29","type_desc":"PRACTITIONER - PULMONARY DISEASE","state":"WI","pac_id":"9739479635"}]},"enumeration_date":"2013-04-01","last_updated":"2019-03-25","_meta":{"source":"NPPES","snapshot_date":"2019-03-25","doc_url":"https://findmynpi.com/api"}}