{"npi":"1336242536","type":"NPI-1","status":"active","name":{"display":"Nicole Bangs P.A.-C.","other":[{"code":"1","type":"Formerly known as","value":"GALLOB, NICOLE J"}],"first":"NICOLE","last":"BANGS","middle":"J","credential":"P.A.-C."},"specialty":{"primary_taxonomy":"363AS0400X","primary_taxonomy_description":"Surgical Physician Assistant","slug":"surgical-physician-assistant","schema_org_specialty":null,"all":[{"code":"363AS0400X","description":"Surgical Physician Assistant","primary":true,"state":"OR","license":"PA156470"}]},"addresses":[{"purpose":"LOCATION","street_1":"1600 STATE ST","city":"SALEM","state":"OR","postal_code":"973014257","country_code":"US","phone":"5035406300","fax":"5035406404"},{"purpose":"MAILING","street_1":"1600 STATE ST","city":"SALEM","state":"OR","postal_code":"973014257","country_code":"US","phone":"5035406300","fax":"5035406404"}],"license":{"state":"OR","number":"PA156470"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"500640158","state":"OR","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20111108000383","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"OR","pac_id":"8224035134"}]},"enumeration_date":"2006-09-06","last_updated":"2014-02-13","_meta":{"source":"NPPES","snapshot_date":"2014-02-13","doc_url":"https://findmynpi.com/api"}}