Elfriede E Vernon, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA13986 Issued in CA

Practice address

6351 Wetzel Ave BLDG 1525
Fort Carson, CO 80913-4188

Phone

(719) 524-4664

Fax

(719) 524-2116

NPI assigned

May 8, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1205003324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6351 WETZEL AVE BLDG 1525",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134188",
            "telephone_number": "719-524-4664",
            "fax_number": "719-524-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6351 WETZEL AVE BLDG 1525",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134188",
            "telephone_number": "719-524-4664",
            "fax_number": "719-524-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNON",
        "first_name": "ELFRIEDE",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-08",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA13986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA13986",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richell Ann Vannieuwenhuyzen
• Bryce Vaughn, PA
• Alesia Marcella Vega, RN
• Stefano Vendraminetto
• Robert Ventura, P.A-C
• Ryan Vetor, M.D.
• Kenneth J Victor, PSY. D.
• Nick Vigil, PA-C
• Gabriel Andres Villalba, DMD
• Leslie Ann Villalobos

• Medical Physician Assistant in Fort Carson, CO
• Providers in Fort Carson, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.