Individual provider Active NPI

Nancyann Pawlik Guthrie, MD

  • Surgery Physician
  • San Luis Obispo, CA
National Provider Identifier
1306847611
Registry record updated May 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G54852 Issued in CA
Practice address
437 Marsh St
San Luis Obispo, CA 93401-3822
Phone
(805) 783-7044
Fax
(805) 783-7047
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G54852 CA Primary

Addresses

Primary practice location

437 Marsh St
San Luis Obispo, CA 93401-3822

Mailing address

437 Marsh St
San Luis Obispo, CA 93401-3822
Phone (805) 783-7044

Other identifiers 1

IdentifierTypeStateIssuer
00G548520MedicaidCA

Other names 1

  • Nancy Ann Pawlik Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070405000171 CA Practitioner - General SurgeryPractitioner - Thoracic SurgeryPractitioner - Peripheral Vascular DiseasePractitioner - Vascular Surgery 2769586403 Practice locations: Arrroyo Grande, CA; San Luis Obispo, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G54852CAMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431561600000",
    "number": "1306847611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 MARSH ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013822",
            "telephone_number": "805-783-7044",
            "fax_number": "805-783-7047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 MARSH ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013822",
            "telephone_number": "805-783-7044",
            "fax_number": "805-783-7047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTHRIE",
        "first_name": "NANCYANN",
        "middle_name": "PAWLIK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2015-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G54852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G548520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "PAWLIK",
            "middle_name": "ANN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.