Individual provider Active NPI

Mary Elizabeth Gould, RN BSN PHN

  • School Registered Nurse
  • Vista, CA
National Provider Identifier
1609346501
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
369948 Issued in CA
Practice address
1234 Arcadia Ave
Vista, CA 92084-3404
Phone
(760) 310-8319
NPI assigned
Dec 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 369948 CA Primary

Addresses

Primary practice location

1234 Arcadia Ave
Vista, CA 92084-3404

Mailing address

12780 Big Bend Way
Valley Center, CA 92082-6450
Phone (760) 505-0420

Other names 1

  • Miss Mary Elizabeth Reimann 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)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
369948CAMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1609346501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12780 BIG BEND WAY",
            "city": "VALLEY CENTER",
            "state": "CA",
            "postal_code": "920826450",
            "telephone_number": "760-505-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 ARCADIA AVE",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920843404",
            "telephone_number": "760-310-8319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULD",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "RN BSN PHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-04",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "CA",
            "license": "369948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "REIMANN",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "credential": "RN BSN PHN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; 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.