Active NPI
Ellen Barnett, M.D.
- General Practice Physician
- Santa Rosa, CA
National Provider Identifier
1184778094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- A368950
- Practice address
- 175 Concourse Blvd
Santa Rosa, CA 95403-8217 - Phone
- (707) 284-9206
- Fax
- (707) 284-9254
- NPI assigned
- Jan 22, 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | A368950 | CA | Primary |
Addresses
Primary practice location
175 Concourse Blvd
Santa Rosa, CA 95403-8217
Mailing address
175 Concourse Blvd
Santa Rosa, CA 95403-8217
Phone (707) 284-9206
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 680452627 | Other | CA | TAX ID# |
| A368950 | Other | CA | 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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A368950 | CA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320278400000",
"number": "1184778094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 CONCOURSE BLVD",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954038217",
"telephone_number": "707-284-9206",
"fax_number": "707-284-9254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 CONCOURSE BLVD",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954038217",
"telephone_number": "707-284-9206",
"fax_number": "707-284-9254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARNETT",
"first_name": "ELLEN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2011-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "A368950",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID#",
"identifier": "680452627",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "A368950",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.