Tonopah Primary Care LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN002866 Issued in NV

Legal business name

TONOPAH PRIMARY CARE LLC

Practice address

119 St. Patrick
Tonopah, NV 89049

Phone

(775) 482-9898

Fax

(775) 482-9900

NPI assigned

May 9, 2018

Last updated

May 9, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eljena Marie Peterson, APRNNPI 1306341656

Title

Manager

Phone

(775) 482-9898

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eljena Marie Peterson, APRN FNP

  • Family Nurse Practitioner
  • Tonopah, NV
  • NPI 1306341656
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525824000000",
    "number": "1003305616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1628",
            "city": "TONOPAH",
            "state": "NV",
            "postal_code": "890491628",
            "telephone_number": "775-482-9898",
            "fax_number": "775-482-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 ST. PATRICK",
            "city": "TONOPAH",
            "state": "NV",
            "postal_code": "89049",
            "telephone_number": "775-482-9898",
            "fax_number": "775-482-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TONOPAH PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-05-09",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "ELJENA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "775-482-9898",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Singleton
• Julie Ann Stage-Rosenberg, RDH, MPH
• State of Nevada (Tonopah Mental Health Center)
• Craig A Strobel, D.O.
• Dacota J Terry
• Beraldo A Vazquez Correa, MD
• Christopher John Vondippe, M.D.
• Westcare Nevada Inc

• Family Nurse Practitioner in Tonopah, NV
• Providers in Tonopah, NV by specialty
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.