Active NPI
Elizabeth Mercado
- Family Nurse Practitioner
- Liberal, KS
National Provider Identifier
1215571344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 79075
- Practice address
- 502 N Kansas Ave
Liberal, KS 67901-3304 - Phone
- (620) 417-0028
- NPI assigned
- Oct 31, 2019
- Last updated
- Dec 30, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 79075 | KS | Primary |
Addresses
Primary practice location
502 N Kansas Ave
Liberal, KS 67901-3304
Mailing address
502 N Kansas Ave
Liberal, KS 67901-3304
Phone (620) 417-0028
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 |
|---|---|---|---|
| 79075 | KS | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577664000000",
"number": "1215571344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "502 N KANSAS AVE",
"city": "LIBERAL",
"state": "KS",
"postal_code": "679013304",
"telephone_number": "620-417-0028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "502 N KANSAS AVE",
"city": "LIBERAL",
"state": "KS",
"postal_code": "679013304",
"telephone_number": "620-417-0028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERCADO",
"first_name": "ELIZABETH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-31",
"last_updated": "2019-12-30",
"certification_date": "2019-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KS",
"license": "79075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Liberal, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.