{"npi":"1366054116","type":"NPI-1","status":"active","name":{"display":"Stephanie Blaha PA-C","other":[],"first":"STEPHANIE","last":"BLAHA","middle":"NICOLE","credential":"PA-C"},"specialty":{"primary_taxonomy":"363A00000X","primary_taxonomy_description":"Physician Assistant","slug":"physician-assistant","schema_org_specialty":null,"all":[{"code":"363A00000X","description":"Physician Assistant","primary":false,"state":"IL","license":"085.007939"},{"code":"363A00000X","description":"Physician Assistant","primary":true,"state":"WI","license":"5115-23"}]},"addresses":[{"purpose":"LOCATION","street_1":"5900 S LAKE DR","city":"CUDAHY","state":"WI","postal_code":"531103171","country_code":"US","phone":"4144899000","fax":"4144894153"},{"purpose":"MAILING","street_1":"5900 S LAKE DR","city":"CUDAHY","state":"WI","postal_code":"531103171","country_code":"US","phone":"4144899000","fax":"4144894153"}],"license":{"state":"WI","number":"5115-23"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"100184745","state":"WI","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20210121000834","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"IL","pac_id":"4981018645"},{"enrlmt_id":"I20211101000176","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"WI","pac_id":"4981018645"}]},"enumeration_date":"2020-08-21","last_updated":"2023-10-06","_meta":{"source":"NPPES","snapshot_date":"2023-10-06","doc_url":"https://findmynpi.com/api"}}