{"npi":"1720107824","type":"NPI-1","status":"active","name":{"display":"Dr. Nicholas Nussbaum M.D.","other":[],"first":"NICHOLAS","last":"NUSSBAUM","middle":"LEE","credential":"M.D."},"specialty":{"primary_taxonomy":"207Q00000X","primary_taxonomy_description":"Family Medicine","slug":"family-medicine","schema_org_specialty":"PrimaryCare","all":[{"code":"207Q00000X","description":"Family Medicine","primary":true,"state":"IN","license":"01063067A"}]},"addresses":[{"purpose":"LOCATION","street_1":"1819 CAREW ST","city":"FORT WAYNE","state":"IN","postal_code":"468054705","country_code":"US","phone":"2603737770","fax":"2603737775"},{"purpose":"MAILING","street_1":"205 TOWER DR","city":"MONROE","state":"IN","postal_code":"467729362","country_code":"US","phone":"2606926163","fax":"2607283949"}],"license":{"state":"IN","number":"01063067A"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"200970670","state":"IN","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20080721000535","type_code":"14-08","type_desc":"PRACTITIONER - FAMILY PRACTICE","state":"IN","pac_id":"9830262070"}]},"enumeration_date":"2007-03-28","last_updated":"2026-04-03","_meta":{"source":"NPPES","snapshot_date":"2026-04-03","doc_url":"https://findmynpi.com/api"}}