{"npi":"1750685335","type":"NPI-1","status":"active","name":{"display":"Udo Foreman PA-C","other":[],"first":"UDO","last":"FOREMAN","middle":"G","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":"MI","license":"5601006199"},{"code":"363A00000X","description":"Physician Assistant","primary":false,"state":"CO","license":"3145"},{"code":"363A00000X","description":"Physician Assistant","primary":false,"state":"NE","license":"2745"},{"code":"363A00000X","description":"Physician Assistant","primary":true,"state":"KS","license":"15-02569"}]},"addresses":[{"purpose":"LOCATION","street_1":"100 MICHIGAN ST NE","city":"GRAND RAPIDS","state":"MI","postal_code":"495032560","country_code":"US","phone":"6163911680"},{"purpose":"MAILING","street_1":"2537 MOMENTUM PL","city":"CHICAGO","state":"IL","postal_code":"606895325","country_code":"US","street_2":"SUITE 200","phone":"6169751845","fax":"6162850846"}],"license":{"state":"KS","number":"15-02569"},"identifiers":[{"type_code":"01","label":"Other","value":"5410563","state":"MI","issuer":"BCBSM PIN"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20200713000256","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"CO","pac_id":"2062687924"},{"enrlmt_id":"I20220201002764","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"KS","pac_id":"2062687924"},{"enrlmt_id":"I20230208001648","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"NE","pac_id":"2062687924"}]},"enumeration_date":"2010-12-22","last_updated":"2025-02-05","_meta":{"source":"NPPES","snapshot_date":"2025-02-05","doc_url":"https://findmynpi.com/api"}}