Individual provider Active NPI

Elizabeth Anne Chase, NP

  • Pediatric Nurse Practitioner
  • Walnut Creek, CA
National Provider Identifier
1093100562
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5379 Issued in CA
Practice address
2634 Grande Camino
Walnut Creek, CA 94598-3509
Phone
(925) 324-0044
NPI assigned
Apr 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 5379 CA Primary

Addresses

Primary practice location

2634 Grande Camino
Walnut Creek, CA 94598-3509

Mailing address

2634 Grande Camino
Walnut Creek, CA 94598-3509
Phone (925) 324-0044

Other names 1

  • Beth Anne Chase Other name

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5379CAMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427846400000",
    "number": "1093100562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2634 GRANDE CAMINO",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983509",
            "telephone_number": "925-324-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2634 GRANDE CAMINO",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983509",
            "telephone_number": "925-324-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHASE",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2015-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "5379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETH",
            "last_name": "CHASE",
            "middle_name": "ANNE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.