Active NPI
Elizabeth A Garrett
- Family Medicine Physician
- Columbia, MO
National Provider Identifier
1073571055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 36165
- Practice address
- 3217 S Providence Rd
Columbia, MO 65203-3639 - Phone
- (573) 884-8700
- Fax
- (573) 884-5604
- NPI assigned
- May 1, 2006
- Last updated
- Dec 27, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 36165 | MO | Primary |
Addresses
Primary practice location
3217 S Providence Rd
Columbia, MO 65203-3639
Mailing address
PO Box 7687
Columbia, MO 65205-7687
Phone (573) 882-2259
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2086331401 | Other | KS | KANSAS MEDICAID |
| 102474 | Other | MO | HEALTHLINK |
| 104136 | Other | MO | UNITED HEALTHCARE |
| 13038 | Other | MO | BLUE SHIELD/BLUE CHOICE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198713600000",
"number": "1073571055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7687",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652057687",
"telephone_number": "573-882-2259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3217 S PROVIDENCE RD",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652033639",
"telephone_number": "573-884-8700",
"fax_number": "573-884-5604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARRETT",
"first_name": "ELIZABETH",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-01",
"last_updated": "2007-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "36165",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KANSAS MEDICAID",
"identifier": "2086331401",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "102474",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "104136",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD/BLUE CHOICE",
"identifier": "13038",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.