Individual provider Active NPI

Annette Michelle Ewing, N.P.

  • Family Nurse Practitioner
  • Atascadero, CA
National Provider Identifier
1407206956
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95004426 Issued in CA
Practice address
9700 El Camino Real Ste 100
Atascadero, CA 93422
Phone
(805) 900-0554
NPI assigned
Jun 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95004426 CA Primary

Addresses

Primary practice location

9700 El Camino Real Ste 100
Atascadero, CA 93422

Mailing address

9700 El Camino Real Ste 100
Atascadero, CA 93422-5571
Phone (805) 900-0554

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170310001681 CA Practitioner - Nurse Practitioner 3476837410 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95004426CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Monterey County Memorial Hospital CurrentSince Feb 1, 2017 Accepting new patients
Central Coast Urgent Care Inc CurrentSince Apr 25, 2018 Accepting new patients

Locations

9700 El Camino Real
Ste 100
Atascadero, CA 93422
Phone (805) 461-9000

1028 N Douty St
Hanford, CA 93230
Phone (559) 530-2526

210 Canal St
King City, CA 93930
Phone (931) 385-7100

300 Canal St
King City, CA 93930
Phone (831) 385-6000

400 Canal St
Ste B
King City, CA 93930
Phone (831) 385-1280

783 Quintana Rd
Ste 1
Morro Bay, CA 93442
Phone (805) 771-0108

2 James Way
Ste 214
Pismo Beach, CA 93449
Phone (805) 295-6594

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1407206956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 EL CAMINO REAL STE 100",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934225571",
            "telephone_number": "805-900-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9700 EL CAMINO REAL STE 100",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "93422",
            "telephone_number": "805-900-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWING",
        "first_name": "ANNETTE",
        "middle_name": "MICHELLE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-15",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95004426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atascadero, CA

Sources for this page

Verify at the official NPI Registry.