NPIMap

Individual provider Active NPI

Elizabeth Spellmeyer, NP

  • Nurse Practitioner
  • Eureka, CA
National Provider Identifier
1194126680
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95005116 Issued in CA
Practice address
2200 Tydd Steet
Eureka, CA 95501
Phone
(707) 441-1624
Fax
(707) 441-1253
NPI assigned
Sep 16, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60258208 WA
Rehabilitation Registered Nurse 163WR0400X 201240461RN OR
Nurse Practitioner 363L00000X 95005116 CA Primary

Addresses

Primary practice location

2200 Tydd Steet
Eureka, CA 95501

Mailing address

670 9TH Street
Suite 203
Arcata, CA 95521
Phone (707) 826-8633

Other names 1

  • Elizabeth Sottero Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161208001379 CA Practitioner - Nurse Practitioner 7315227386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Open Door Community Health Centers 113 clinicians

Practice addresses (Care Compare)

1644 Central Ave
McKinleyville, CA 95519-4342
Phone (707) 839-3068

Hospital & facility affiliations

  • Providence St Joseph Hospital Hospital, Eureka, CA, CCN 050006
  • Mad River Community Hospital Hospital, Arcata, CA, CCN 050028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN60258208WAMDRegistered Nurse
201240461RNORMDRehabilitation Registered Nurse
95005116CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Community Health Centers CurrentSince Oct 29, 2016 Accepting new patients
Open Door Community Health Centers Current Accepting new patients
Open Door Community Health Centers CurrentSince Oct 29, 2016 Accepting new patients
Open Door Community Health Centers Current Accepting new patients

Locations

785 18th St
Arcata, CA 95521
Phone (707) 822-2481

1275 8th St
Arcata, CA 95521

770 10th St
Arcata, CA 95521
Phone (707) 826-8610

2200 Tydd St
Eureka, CA 95501
Phone (707) 269-7051

1644 Central Ave
McKinleyville, CA 95519
Phone (707) 839-3068

670 9th St
Ste 203
McKinleyville, CA 95521

Interoperability endpoints

  • Direct secure messaging: espellmeyer190254@direct.ochin.org

Organizations & group practices 12

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1194126680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 9TH STREET",
            "address_2": "SUITE 203",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "95521",
            "telephone_number": "707-826-8633",
            "fax_number": "707-826-8628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 TYDD STEET",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "95501",
            "telephone_number": "707-441-1624",
            "fax_number": "707-441-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPELLMEYER",
        "first_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60258208",
            "primary": false
        },
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "OR",
            "license": "201240461RN",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95005116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "SOTTERO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.