Individual provider Active NPI

Peggy Schwartz Chipkin, RN, NP, FNP

  • Nurse Practitioner
  • Mill Valley, CA
National Provider Identifier
1114647708
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
223224 Issued in CA
Practice address
158 E Blithedale Ave Ste F
Mill Valley, CA 94941-2060
Phone
(415) 389-8589
NPI assigned
Sep 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 223224 CA Primary

Addresses

Primary practice location

158 E Blithedale Ave Ste F
Mill Valley, CA 94941-2060

Mailing address

158 E Blithedale Ave Ste F
Mill Valley, CA 94941-2060
Phone (415) 389-8589

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, Registered Nurse

State licenses

LicenseStateTypeSpecialty
223224CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1114647708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 E BLITHEDALE AVE STE F",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412060",
            "telephone_number": "415-389-8589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 E BLITHEDALE AVE STE F",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412060",
            "telephone_number": "415-389-8589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIPKIN",
        "first_name": "PEGGY",
        "middle_name": "SCHWARTZ",
        "credential": "RN, NP, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "223224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; 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.