{"npi":"1184616625","type":"NPI-1","status":"active","name":{"display":"Lance Lagerstrom CRNA","other":[],"first":"LANCE","last":"LAGERSTROM","credential":"CRNA"},"specialty":{"primary_taxonomy":"367500000X","primary_taxonomy_description":"Certified Registered Nurse Anesthetist","slug":"certified-registered-nurse-anesthetist","schema_org_specialty":null,"all":[{"code":"367500000X","description":"Certified Registered Nurse Anesthetist","primary":true,"state":"TX","license":"052743"}]},"addresses":[{"purpose":"LOCATION","street_1":"520 E 6TH ST","city":"ODESSA","state":"TX","postal_code":"797614527","country_code":"US","phone":"4323348088","fax":"4325807202"},{"purpose":"MAILING","street_1":"PO BOX 1226","city":"ODESSA","state":"TX","postal_code":"797601226","country_code":"US","phone":"4323348088","fax":"4325807202"}],"license":{"state":"TX","number":"052743"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"164828902","state":"TX","issuer":null},{"type_code":"01","label":"Other","value":"85594U","state":"TX","issuer":"BCBSTX"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20231026002893","type_code":"14-43","type_desc":"PRACTITIONER - CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)","state":"VA","pac_id":"3274515192"}]},"enumeration_date":"2005-08-19","last_updated":"2022-11-17","_meta":{"source":"NPPES","snapshot_date":"2022-11-17","doc_url":"https://findmynpi.com/api"}}