Elsa E. Tesfasion

Primary specialty

Nursing Home AdministratorTaxonomy code 376G00000X

License

AL8568H Issued in AZ

Practice address

9003 W Charleston Ave
Peoria, AZ 85382-8106

Phone

(623) 444-7140

Fax

(623) 444-7140

NPI assigned

Jul 7, 2015

Last updated

Jul 10, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436486400000",
    "number": "1073996179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9003 W CHARLESTON AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853828106",
            "telephone_number": "623-444-7140",
            "fax_number": "623-444-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9003 W CHARLESTON AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853828106",
            "telephone_number": "623-444-7140",
            "fax_number": "623-444-7140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESFASION",
        "first_name": "ELSA",
        "middle_name": "E.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2015-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "AZ",
            "license": "AL8568H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "863798",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nursing Home Administrator in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Nursing Home Administrator in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; 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.