Active NPI
Elizabeth McKenzie Kipe, PA
- Physician Assistant
- San Ramon, CA
National Provider Identifier
1184235376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 57957
- Practice address
- 100 Park PL Ste 200
San Ramon, CA 94583-4416 - Phone
- (925) 867-1800
- NPI assigned
- Aug 12, 2020
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 57957 | CA | Primary |
Addresses
Primary practice location
100 Park PL Ste 200
San Ramon, CA 94583-4416
Mailing address
380A 49TH St
Oakland, CA 94609-2237
Phone (949) 350-0059
Other names 1
- Miss McKenzie Kipe
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57957 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597190400000",
"number": "1184235376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "380A 49TH ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946092237",
"telephone_number": "949-350-0059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 PARK PL STE 200",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945834416",
"telephone_number": "925-867-1800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIPE",
"first_name": "ELIZABETH",
"middle_name": "MCKENZIE",
"name_prefix": "Miss",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-12",
"last_updated": "2020-08-12",
"certification_date": "2020-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "57957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MCKENZIE",
"last_name": "KIPE",
"prefix": "MISS",
"credential": "PA",
"code": "5",
"type": "Other Name"
}
]
}Other providers in San Ramon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.