Active NPI
Elizabeth Mary Vennos, M.D.
- Dermatology Physician
- Bellingham, WA
National Provider Identifier
1033169511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- MD00032564
- Practice address
- 2075 Barkley Blvd
Suite 230
Bellingham, WA 98226 - Phone
- (360) 647-2188
- Fax
- (360) 756-0802
- NPI assigned
- May 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | MD00032564 | WA | Primary |
Addresses
Primary practice location
2075 Barkley Blvd
Suite 230
Bellingham, WA 98226
Mailing address
2075 Barkley Blvd
Suite 225
Bellingham, WA 98226
Phone (360) 647-2188
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jul 28, 2015 through Jul 28, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00032564 | WA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384387200000",
"number": "1033169511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2075 BARKLEY BLVD",
"address_2": "SUITE 225",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "98226",
"telephone_number": "360-647-2188",
"fax_number": "360-756-0802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2075 BARKLEY BLVD",
"address_2": "SUITE 230",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "98226",
"telephone_number": "360-647-2188",
"fax_number": "360-756-0802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENNOS",
"first_name": "ELIZABETH",
"middle_name": "MARY",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-12",
"last_updated": "2013-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "WA",
"license": "MD00032564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.