{
"Npi": {
"NPI": "1053705020",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "STROUD",
"FirstName": "JARED",
"MiddleName": "MATTHEW",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "700 ACKERMAN RD STE 2120",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COLUMBUS",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43202-1559",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "614-293-5123",
"MailingAddressFaxNumber": "614-293-4890",
"FirstLinePracticeLocationAddress": "393 E TOWN ST STE 116",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "COLUMBUS",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "43215-4799",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "614-566-9000",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/26/2015",
"LastUpdateDate": "03/28/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207RG0300X",
"TaxonomyName": "Geriatric Medicine (Internal Medicine) Physician",
"LicenseNumber": "35.131692",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "35.131692",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}