{"npi":"1831628841","type":"NPI-1","status":"active","name":{"display":"Loc DO Physician Assistant","other":[],"first":"LOC","last":"DO","middle":"VAN","credential":"PHYSICIAN ASSISTANT"},"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":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"505 ELM ST NE","city":"ALBUQUERQUE","state":"NM","postal_code":"871022500","country_code":"US","phone":"5057274700"},{"purpose":"MAILING","street_1":"10001 COORS BYP NW APT 313","city":"ALBUQUERQUE","state":"NM","postal_code":"871144142","country_code":"US","phone":"4082056681"}],"license":null,"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20171017001708","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"NM","pac_id":"5597036871"},{"enrlmt_id":"I20251224000650","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"CA","pac_id":"5597036871"}]},"enumeration_date":"2017-06-05","last_updated":"2017-06-05","_meta":{"source":"NPPES","snapshot_date":"2017-06-05","doc_url":"https://findmynpi.com/api"}}