Individual provider Active NPI

Elizabeth Ann Sano, APRN

  • Pediatric Nurse Practitioner
  • Conshohocken, PA
National Provider Identifier
1023404555
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN724709 Issued in PA
Practice address
625 W Ridge Pike Ste 300
Conshohocken, PA 19428-1180
Phone
(610) 825-1994
Fax
(610) 825-2949
NPI assigned
Apr 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN724709 PA Primary
Pediatric Nurse Practitioner 363LP0200X RN399351 OH

Addresses

Primary practice location

625 W Ridge Pike Ste 300
Conshohocken, PA 19428-1180

Mailing address

324 E Jefferson St
Media, PA 19063-3804
Phone (937) 776-2799

Other names 1

  • Ms. Elizabeth Ann Botts Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
RN399351OHMDPediatric Nurse Practitioner
RN724709PAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Pediatrics, Inc. PastSince Jul 28, 2019 Accepting new patients
True North Medical Group, LLC PastSince Jan 26, 2022 Accepting new patients
True North Medical Group, LLC PastSince Jan 26, 2022 Accepting new patients
Ohio Pediatrics, Inc. PastSince Jul 28, 2019 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1023404555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 E JEFFERSON ST",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633804",
            "telephone_number": "937-776-2799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W RIDGE PIKE STE 300",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194281180",
            "telephone_number": "610-825-1994",
            "fax_number": "610-825-2949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANO",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "RN724709",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "RN399351",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "BOTTS",
            "middle_name": "ANN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Conshohocken, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.