{"npi":"1255375903","type":"NPI-1","status":"active","name":{"display":"Mr. Charles Otero PA","other":[],"first":"CHARLES","last":"OTERO","middle":"DANIEL","credential":"PA"},"specialty":{"primary_taxonomy":"363A00000X","primary_taxonomy_description":"Physician Assistant","slug":"physician-assistant","schema_org_specialty":null,"all":[{"code":"363A00000X","description":"Physician Assistant","primary":true,"state":"NM","license":"93-PA01"}]},"addresses":[{"purpose":"LOCATION","street_1":"701 ARIZONA ST","city":"CLOVIS","state":"NM","postal_code":"881012110","country_code":"US","street_2":"SUITE A","phone":"5757423033","fax":"5757421133"},{"purpose":"MAILING","street_1":"701 ARIZONA ST","city":"CLOVIS","state":"NM","postal_code":"881012110","country_code":"US","street_2":"SUITE A","phone":"5757423033","fax":"5757421133"}],"license":{"state":"NM","number":"93-PA01"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"97903","state":"NM","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20040120000457","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"NM","pac_id":"8921909557"}]},"enumeration_date":"2006-06-15","last_updated":"2016-12-27","_meta":{"source":"NPPES","snapshot_date":"2016-12-27","doc_url":"https://findmynpi.com/api"}}