{"npi":"1487604906","type":"NPI-1","status":"active","name":{"display":"Dr. Anthony Balcom MD","other":[],"first":"ANTHONY","last":"BALCOM","middle":"H","credential":"MD"},"specialty":{"primary_taxonomy":"2088P0231X","primary_taxonomy_description":"Pediatric Urology Physician","slug":"pediatric-urology-physician","schema_org_specialty":null,"all":[{"code":"208800000X","description":"Urology Physician","primary":false,"state":"WI","license":"26912"},{"code":"2088P0231X","description":"Pediatric Urology Physician","primary":false,"state":"TX","license":"V8461"},{"code":"2088P0231X","description":"Pediatric Urology Physician","primary":true,"state":"WI","license":"26912"}]},"addresses":[{"purpose":"LOCATION","street_1":"5250 S 108TH ST","city":"HALES CORNERS","state":"WI","postal_code":"531301321","country_code":"US","phone":"4145252400","fax":"4145252401"},{"purpose":"MAILING","street_1":"5250 S 108TH ST","city":"HALES CORNERS","state":"WI","postal_code":"531301321","country_code":"US","phone":"4145252400","fax":"4145252401"}],"license":{"state":"WI","number":"26912"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"1487604906","state":"WI","issuer":null},{"type_code":"01","label":"Other","value":"007000261M","state":null,"issuer":"HUMANA"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20041008001323","type_code":"14-34","type_desc":"PRACTITIONER - UROLOGY","state":"WI","pac_id":"6608835103"}]},"enumeration_date":"2006-05-12","last_updated":"2025-12-23","_meta":{"source":"NPPES","snapshot_date":"2025-12-23","doc_url":"https://findmynpi.com/api"}}