Individual provider Active NPI

Elizabeth Marie Hamstra, APRN

  • Pediatrics Physician
  • Palmetto, FL
National Provider Identifier
1023785755
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2021007304 Issued in MO
Practice address
218 9TH Street Dr W
Palmetto, FL 34221-4802
Phone
(941) 721-3900
NPI assigned
Aug 30, 2021
Last updated
Dec 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN1101343 FL
Pediatric Nurse Practitioner 363LP0200X 2021007304 MO
Pediatric Nurse Practitioner 363LP0200X 4704422645 MI
Pediatrics Physician 208000000X 2021007304 MO Primary

Addresses

Primary practice location

218 9TH Street Dr W
Palmetto, FL 34221-4802

Mailing address

912 NW 10TH St
Blue Springs, MO 64015-3058
Phone (816) 240-3665

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

State licenses

LicenseStateTypeSpecialty
APRN1101343FLMDPediatric Nurse Practitioner
4704422645MIMDPediatric Nurse Practitioner
2021007304MOMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shreeji Inc Pediatrics PastSince Dec 15, 2024 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1023785755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 NW 10TH ST",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640153058",
            "telephone_number": "816-240-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 9TH STREET DR W",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342214802",
            "telephone_number": "941-721-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMSTRA",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN1101343",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2021007304",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704422645",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2021007304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmetto, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.