NPIMap

Individual provider Active NPI

Elaine J Charteris, ANP

  • Adult Health Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1508949561
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN099653 Issued in AZ
Practice address
1775 E Skyline Dr
#101
Tucson, AZ 85718-1162
Phone
(520) 615-6200
Fax
(520) 615-6255
NPI assigned
Oct 23, 2006
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
Adult Health Nurse Practitioner 363LA2200X RN099653 AZ Primary

Addresses

Primary practice location

1775 E Skyline Dr
#101
Tucson, AZ 85718-1162

Mailing address

1775 E Skyline Dr
#101
Tucson, AZ 85718-1162
Phone (520) 615-6200

Other identifiers 1

IdentifierTypeStateIssuer
826951MedicaidAZ

Other names 1

  • Elaine J Chanecka Former name

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN099653AZMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pima Heart Physicians, PC Past Accepting new patients
Tucson Vascular Surgery Past Accepting new patients
Pima Heart Physicians, PC Past Accepting new patients
Pima Heart Physicians, PC Past Accepting new patients

Organizations & group practices 4

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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508949561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 E SKYLINE DR",
            "address_2": "#101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857181162",
            "telephone_number": "520-615-6200",
            "fax_number": "520-615-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 E SKYLINE DR",
            "address_2": "#101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857181162",
            "telephone_number": "520-615-6200",
            "fax_number": "520-615-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARTERIS",
        "first_name": "ELAINE",
        "middle_name": "J",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "RN099653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "826951",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELAINE",
            "last_name": "CHANECKA",
            "middle_name": "J",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tucson, AZ

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.