Active NPI
Elaine Loth, PNP
- Pediatric Nurse Practitioner
- Stockton, CA
National Provider Identifier
1164548103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RN557498
- Practice address
- 89 W March LN
Ste #1
Stockton, CA 95207-5721 - Phone
- (209) 478-2622
- NPI assigned
- Mar 21, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | RN557498 | CA | Primary |
Addresses
Primary practice location
89 W March LN
Ste #1
Stockton, CA 95207-5721
Mailing address
89 W March LN
Ste #1
Stockton, CA 95207-5721
Phone (209) 478-2622
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN557498 | Other | CA | RN LICENSE |
| NP12548 | Other | CA | FURNISHING LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN557498 | CA | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164548103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "89 W MARCH LN",
"address_2": "STE #1",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952075721",
"telephone_number": "209-478-2622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "89 W MARCH LN",
"address_2": "STE #1",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952075721",
"telephone_number": "209-478-2622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOTH",
"first_name": "ELAINE",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CA",
"license": "RN557498",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE",
"identifier": "RN557498",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FURNISHING LICENSE",
"identifier": "NP12548",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.