Individual provider Active NPI

Edith Lorena Spottiswood

  • Family Nurse Practitioner
  • Lancaster, CA
National Provider Identifier
1093415069
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95024520 Issued in CA
Practice address
1600 W Avenue J
Lancaster, CA 93534-2814
Phone
(661) 949-5000
NPI assigned
Mar 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95024520 CA Primary

Addresses

Primary practice location

1600 W Avenue J
Lancaster, CA 93534-2814

Mailing address

4134 Vahan CT
Lancaster, CA 93536-6838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20231207000518 CA Practitioner - Nurse Practitioner 9234588971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Antelope Valley Emergency Medical Associates IncGroup PAC ID 7517851959, 34 clinicians

Practice addresses (Care Compare)

1600 W Ave J
Lancaster, CA 93534-2814
Phone (661) 949-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.53 of 100Reported as group
Quality
85.33
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Antelope Valley Emergency Medical Associates Inc CurrentSince Oct 17, 2023 Accepting new patients

Locations

1600 W Avenue J
Lancaster, CA 93534
Phone (661) 726-6254

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1093415069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4134 VAHAN CT",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935366838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W AVENUE J",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342814",
            "telephone_number": "661-949-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPOTTISWOOD",
        "first_name": "EDITH",
        "middle_name": "LORENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-07",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95024520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.