Individual provider Active NPI

Ann Lloyd Pomphrey, PNP

  • Pediatric Nurse Practitioner
  • Altadena, CA
National Provider Identifier
1417099649
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
289375 Issued in CA
Practice address
1904 Coolidge Ave
Altadena, CA 91001-3563
Phone
(626) 568-4500
Fax
(626) 578-1204
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 289375 CA Primary

Addresses

Primary practice location

1904 Coolidge Ave
Altadena, CA 91001-3563

Mailing address

1904 Coolidge Avenue
Altadena, CA 91001-3563
Phone (626) 568-4500

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

LicenseStateTypeSpecialty
289375CAMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417099649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 COOLIDGE AVENUE",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910013563",
            "telephone_number": "626-568-4500",
            "fax_number": "626-578-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 COOLIDGE AVE",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910013563",
            "telephone_number": "626-568-4500",
            "fax_number": "626-578-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMPHREY",
        "first_name": "ANN",
        "middle_name": "LLOYD",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "289375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.