Active NPI
Ellen Penny Buchholz, ARNP
- Pediatric Nurse Practitioner
- Lantana, FL
National Provider Identifier
1609090299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- ARNP 1486232
- Practice address
- 1250 Southwinds Dr
Lantana, FL 33462-1459 - Phone
- (561) 582-5559
- Fax
- (561) 439-4384
- NPI assigned
- Apr 13, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | ARNP 1486232 | FL | Primary |
Addresses
Primary practice location
1250 Southwinds Dr
Lantana, FL 33462-1459
Mailing address
2601 10TH Ave N
Suite 100
Palm Springs, FL 33461-3141
Phone (561) 642-1008
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004962400 | Medicaid | FL |
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 |
|---|---|---|---|
| ARNP 1486232 | FL | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423094400000",
"number": "1609090299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2601 10TH AVE N",
"address_2": "SUITE 100",
"city": "PALM SPRINGS",
"state": "FL",
"postal_code": "334613141",
"telephone_number": "561-642-1008",
"fax_number": "561-802-3976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 SOUTHWINDS DR",
"city": "LANTANA",
"state": "FL",
"postal_code": "334621459",
"telephone_number": "561-582-5559",
"fax_number": "561-439-4384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCHHOLZ",
"first_name": "ELLEN",
"middle_name": "PENNY",
"name_prefix": "Ms.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-13",
"last_updated": "2015-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "FL",
"license": "ARNP 1486232",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004962400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lantana, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.