Elizabeth Mintz, R.N., B.S.N.

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

1-159592 Issued in AL

Practice address

171 Rosegate Dr
Calera, AL 35040-4300

Phone

(205) 586-4462

NPI assigned

Nov 7, 2019

Reactivated

Feb 21, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1164067617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 ROSEGATE DR",
            "city": "CALERA",
            "state": "AL",
            "postal_code": "350404300",
            "telephone_number": "205-586-4462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ROSEGATE DR",
            "city": "CALERA",
            "state": "AL",
            "postal_code": "350404300",
            "telephone_number": "205-586-4462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINTZ",
        "first_name": "ELIZABETH",
        "credential": "R.N., B.S.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-07",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "deactivation_date": "2021-12-20",
        "reactivation_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-159592",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-174898",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acute Care Nurse Practitioner in Calera, AL
• Providers in Calera, AL by specialty
• Acute Care Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.