Individual provider Active NPI

Elizabeth A James, PA-C

  • Physician Assistant
  • Bettendorf, IA
National Provider Identifier
1063417558
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001498 Issued in IA
Practice address
3740 Utica Ridge Road
Suite B
Bettendorf, IA 52722-1624
Phone
(563) 344-7400
Fax
(563) 359-9395
NPI assigned
Jun 20, 2005
Last updated
Jul 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001498 IA Primary
Physician Assistant 363A00000X 085002813 IL

Addresses

Primary practice location

3740 Utica Ridge Road
Suite B
Bettendorf, IA 52722-1624

Mailing address

3740 Utica Ridge Road
Suite B
Bettendorf, IA 52722-1624
Phone (563) 344-7400

Other identifiers 2

IdentifierTypeStateIssuer
119454OtherHEALTH ALLIANCE
28579OtherIABCBS

Other names 1

  • Elizabeth A Boline Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061025000015 IA Practitioner - Physician Assistant 2567469109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3740 Utica Ridge Rd
Suite B
Bettendorf, IA 52722-1624
Phone (563) 344-7400

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001498IAMDPhysical Therapy Assistant
085002813ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Dec 1, 2018 Accepting new patients
Iowa Physicians Clinic Medical Foundation Physician Assistant CurrentSince Dec 1, 2018 Accepting new patients
Genesis Health System Past Accepting new patients
Trinity Medical Center Physician Assistant Past Accepting new patients

Locations

3740 Utica Ridge Rd
Ste B
Bettendorf, IA 52722
Phone (563) 344-7400

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

Interoperability endpoints

  • Direct secure messaging: ejames651910@direct.unitypoint.org

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1063417558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 UTICA RIDGE ROAD",
            "address_2": "SUITE B",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221624",
            "telephone_number": "563-344-7400",
            "fax_number": "563-359-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 UTICA RIDGE ROAD",
            "address_2": "SUITE B",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221624",
            "telephone_number": "563-344-7400",
            "fax_number": "563-359-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-20",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001498",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002813",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "119454",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "28579",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "BOLINE",
            "middle_name": "A",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bettendorf, IA

Sources for this page

Verify at the official NPI Registry.