Individual provider Active NPI

Elizabeth J Gower, MD

  • Pediatrics Physician
  • Virginia Beach, VA
National Provider Identifier
1154379022
Registry record updated Dec 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101047362 Issued in VA
Practice address
100 Constitution Dr
Suite 217
Virginia Beach, VA 23462-6799
Phone
(757) 499-7442
Fax
(757) 490-3638
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101047362 VA Primary

Addresses

Primary practice location

100 Constitution Dr
Suite 217
Virginia Beach, VA 23462-6799

Mailing address

1300 Lynnwood Dr
Virginia Beach, VA 23452-6017
Phone (757) 306-8940

Other identifiers 3

IdentifierTypeStateIssuer
105552OtherANTHEM BC/BS
36465OtherOPTIMA
1154379022MedicaidVA

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101047362VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Medical Group Inc Pediatrics Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354838400000",
    "number": "1154379022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 LYNNWOOD DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234526017",
            "telephone_number": "757-306-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CONSTITUTION DR",
            "address_2": "SUITE 217",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626799",
            "telephone_number": "757-499-7442",
            "fax_number": "757-490-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOWER",
        "first_name": "ELIZABETH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2012-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101047362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "105552",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "36465",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154379022",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2012; 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.