{"npi":"1700844313","type":"NPI-1","status":"active","name":{"display":"Kelly Bacon","other":[],"first":"KELLY","last":"BACON"},"specialty":{"primary_taxonomy":"367500000X","primary_taxonomy_description":"Certified Registered Nurse Anesthetist","slug":"certified-registered-nurse-anesthetist","schema_org_specialty":null,"all":[{"code":"367H00000X","description":"Anesthesiologist Assistant","primary":false,"state":"OK","license":"R0071221"},{"code":"367500000X","description":"Certified Registered Nurse Anesthetist","primary":true,"state":"OK","license":"R0071221"}]},"addresses":[{"purpose":"LOCATION","street_1":"1301 E LINCOLN RD","city":"IDABEL","state":"OK","postal_code":"747457300","country_code":"US","phone":"5802867623"},{"purpose":"MAILING","street_1":"PO BOX 1547","city":"SEDALIA","state":"MO","postal_code":"653021547","country_code":"US","phone":"6608265960"}],"license":{"state":"OK","number":"R0071221"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20211101001542","type_code":"14-43","type_desc":"PRACTITIONER - CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)","state":"OK","pac_id":"6103710470"}]},"enumeration_date":"2006-05-03","last_updated":"2021-10-26","_meta":{"source":"NPPES","snapshot_date":"2021-10-26","doc_url":"https://findmynpi.com/api"}}