{"npi":"1700841541","type":"NPI-1","status":"active","name":{"display":"Dr. Mark Kallgren MD","other":[],"first":"MARK","last":"KALLGREN","middle":"A.","credential":"MD"},"specialty":{"primary_taxonomy":"207LP2900X","primary_taxonomy_description":"Anesthesiology, Pain Medicine","slug":"anesthesiology-pain-medicine","schema_org_specialty":"Anesthesia","all":[{"code":"207L00000X","description":"Anesthesiology","primary":false,"state":"OR","license":"MD18182"},{"code":"207L00000X","description":"Anesthesiology","primary":false,"state":"AZ","license":"19539"},{"code":"207LP2900X","description":"Anesthesiology, Pain Medicine","primary":false,"state":"OR","license":"MD18182"},{"code":"207LP2900X","description":"Anesthesiology, Pain Medicine","primary":true,"state":"AZ","license":"19539"}]},"addresses":[{"purpose":"LOCATION","street_1":"645 E MISSOURI AVE STE 300","city":"PHOENIX","state":"AZ","postal_code":"850121351","country_code":"US","phone":"6022628900","fax":"6022628890"},{"purpose":"MAILING","street_1":"645 E MISSOURI AVE STE 300","city":"PHOENIX","state":"AZ","postal_code":"850121351","country_code":"US","phone":"6022628900","fax":"6022628890"}],"license":{"state":"AZ","number":"19539"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"806093700","state":"ID","issuer":null},{"type_code":"01","label":"Other","value":"050039034","state":"OR","issuer":"RR MEDICARE"},{"type_code":"05","label":"Medicaid","value":"070040","state":"OR","issuer":null},{"type_code":"05","label":"Medicaid","value":"8170268","state":"WA","issuer":null},{"type_code":"05","label":"Medicaid","value":"XPY183725","state":"CA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20100922000949","type_code":"14-72","type_desc":"PRACTITIONER - PAIN MANAGEMENT","state":"OR","pac_id":"4587747563"},{"enrlmt_id":"I20190923003432","type_code":"14-72","type_desc":"PRACTITIONER - PAIN MANAGEMENT","state":"AZ","pac_id":"4587747563"}]},"enumeration_date":"2006-04-17","last_updated":"2021-02-25","_meta":{"source":"NPPES","snapshot_date":"2021-02-25","doc_url":"https://findmynpi.com/api"}}