{"npi":"1508085358","type":"NPI-1","status":"active","name":{"display":"Lisa Gore CRNA","other":[{"code":"1","type":"Formerly known as","value":"GORE-SHAW, LISA E"}],"first":"LISA","last":"GORE","middle":"E","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":"MO","license":"124308"}]},"addresses":[{"purpose":"LOCATION","street_1":"404 N KEENE ST","city":"COLUMBIA","state":"MO","postal_code":"652016626","country_code":"US","phone":"5738759224","fax":"5738759284"},{"purpose":"MAILING","street_1":"PO BOX 843966","city":"KANSAS CITY","state":"MO","postal_code":"641843966","country_code":"US","phone":"5738843300","fax":"5738840943"}],"license":{"state":"MO","number":"124308"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"917307001","state":"MO","issuer":null},{"type_code":"01","label":"Other","value":"787653","state":"MO","issuer":"HEALTHLINK"},{"type_code":"01","label":"Other","value":"127254","state":"MO","issuer":"BLUE SHIELD"}],"pecos":{"enrolled_at":"2026-07-01T15:01:53.235063+00:00","enrollments":[{"enrlmt_id":"I20070509000110","type_code":"14-43","type_desc":"PRACTITIONER - CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)","state":"MO","pac_id":"6305942210"}]},"enumeration_date":"2007-04-24","last_updated":"2020-11-05","_meta":{"source":"NPPES","snapshot_date":"2020-11-05","doc_url":"https://findmynpi.com/api"}}