{"npi":"1689770919","type":"NPI-1","status":"active","name":{"display":"Ms. Kelly Polus Pac","other":[],"first":"KELLY","last":"POLUS","credential":"PAC"},"specialty":{"primary_taxonomy":"363A00000X","primary_taxonomy_description":"Physician Assistant","slug":"physician-assistant","schema_org_specialty":null,"all":[{"code":"363A00000X","description":"Physician Assistant","primary":true,"state":"MT","license":"397"}]},"addresses":[{"purpose":"LOCATION","street_1":"610 N CALIFORNIA ST","city":"MISSOULA","state":"MT","postal_code":"598023950","country_code":"US","phone":"4067211646","fax":"4065439890"},{"purpose":"MAILING","street_1":"610 N CALIFORNIA ST","city":"MISSOULA","state":"MT","postal_code":"598023950","country_code":"US","phone":"4067211646","fax":"4065439890"}],"license":{"state":"MT","number":"397"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"4304604","state":"MT","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20050708000474","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"MT","pac_id":"5698701993"}]},"enumeration_date":"2006-09-15","last_updated":"2021-10-07","_meta":{"source":"NPPES","snapshot_date":"2021-10-07","doc_url":"https://findmynpi.com/api"}}