{
"Npi": {
"NPI": "1609079151",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SHUMADINE",
"FirstName": "JASON",
"MiddleName": "THOMAS",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "WOLFF",
"OtherFirstName": "JASON",
"OtherMiddleName": "SHUMADINE",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "MD",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "2401 W BELVEDERE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BALTIMORE",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "21215-5216",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "410-601-5689",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1950 GLENN MITCHELL DR STE 100",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "VIRGINIA BEACH",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23456-0019",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "757-507-0425",
"PracticeLocationAddressFaxNumber": "757-507-0426",
"EnumerationDate": "06/11/2007",
"LastUpdateDate": "08/13/2025",
"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": "2085R0001X",
"TaxonomyName": "Radiation Oncology Physician",
"LicenseNumber": "MD.204262",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2085R0001X",
"TaxonomyName": "Radiation Oncology Physician",
"LicenseNumber": "D0097983",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "2085R0001X",
"TaxonomyName": "Radiation Oncology Physician",
"LicenseNumber": "ME103163",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2085R0001X",
"TaxonomyName": "Radiation Oncology Physician",
"LicenseNumber": "0101238679",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}