{"npi":"1790785756","type":"NPI-1","status":"active","name":{"display":"Jared Ellis MD","other":[],"first":"JARED","last":"ELLIS","middle":"S","credential":"MD"},"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":"AL","license":"17418"}]},"addresses":[{"purpose":"LOCATION","street_1":"2201 JACK WARNER PKWY","city":"TUSCALOOSA","state":"AL","postal_code":"354011090","country_code":"US","phone":"2055235618"},{"purpose":"MAILING","street_1":"2201 JACK WARNER PKWY","city":"TUSCALOOSA","state":"AL","postal_code":"354011090","country_code":"US","phone":"2055235618"}],"license":{"state":"AL","number":"17418"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"1750393682","state":"AL","issuer":null},{"type_code":"05","label":"Medicaid","value":"541392605","state":"AL","issuer":null},{"type_code":"01","label":"Other","value":"1750393682","state":"AL","issuer":"GROUP NPI #"},{"type_code":"05","label":"Medicaid","value":"529700760","state":"AL","issuer":null},{"type_code":"05","label":"Medicaid","value":"541003926","state":"AL","issuer":null},{"type_code":"05","label":"Medicaid","value":"051037554","state":"AL","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20240610001711","type_code":"33-08","type_desc":"ORDER AND REFERRING ONLY - FAMILY PRACTICE","state":"AL","pac_id":"6608784830"}]},"enumeration_date":"2005-07-29","last_updated":"2022-09-01","_meta":{"source":"NPPES","snapshot_date":"2022-09-01","doc_url":"https://findmynpi.com/api"}}