{"npi":"1659375079","type":"NPI-2","status":"active","name":{"display":"Pediatric Associates INC","other":[],"organization_name":"PEDIATRIC ASSOCIATES INC","authorised_official":"David Rusk"},"specialty":{"primary_taxonomy":"208000000X","primary_taxonomy_description":"Pediatrics","slug":"pediatrics","schema_org_specialty":"Pediatric","all":[{"code":"208000000X","description":"Pediatrics","primary":true,"state":"IN","license":"01025325A"}]},"addresses":[{"purpose":"LOCATION","street_1":"7910 W JEFFERSON BLVD","city":"FORT WAYNE","state":"IN","postal_code":"468044159","country_code":"US","street_2":"STE 201","phone":"2604363789","fax":"2604362703"},{"purpose":"MAILING","street_1":"7910 W JEFFERSON BLVD","city":"FORT WAYNE","state":"IN","postal_code":"468044159","country_code":"US","street_2":"STE 201","phone":"2604363789","fax":"2604362703"}],"license":{"state":"IN","number":"01025325A"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"100049720A","state":"IN","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2005-06-13","last_updated":"2024-04-10","_meta":{"source":"NPPES","snapshot_date":"2024-04-10","doc_url":"https://findmynpi.com/api"}}