Individual provider Active NPI

Eve-Marie Welch, PA

  • Physician Assistant
  • South Lake Tahoe, CA
National Provider Identifier
1609933910
Registry record updated Nov 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 18160 Issued in CA
Practice address
2201 South Ave
Ste B
South Lake Tahoe, CA 96150-7025
Phone
(530) 543-5623
Fax
(530) 541-5738
NPI assigned
Jan 3, 2007
Last updated
Nov 7, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 18160 CA Primary

Addresses

Primary practice location

2201 South Ave
Ste B
South Lake Tahoe, CA 96150-7025

Mailing address

1111 Emerald Bay Rd
South Lake Tahoe, CA 96150-6207
Phone (530) 543-5659

Other identifiers 2

IdentifierTypeStateIssuer
1609933910MedicaidNV
1609933910MedicaidCA

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, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 18160CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Barton Healthcare System PastSince Jan 1, 1990 Accepting new patients
Barton Healthcare System PastSince Jan 1, 1990 Accepting new patients
Barton Healthcare System PastSince Jan 1, 1990 Accepting new patients
Barton Ambulatory Clinics PastSince Jan 1, 1990 Accepting new patients
Barton Healthcare System PastSince Jan 1, 1990 Accepting new patients
Barton Healthcare System PastSince Jan 1, 1990 Accepting new patients
Barton Healthcare System PastSince Jan 1, 1990 Accepting new patients
Barton Healthcare System PastSince Jan 1, 1990 Accepting new patients
Barton Healthcare System PastSince Jan 1, 1990 Accepting new patients
Barton Healthcare System PastSince Jan 1, 1990 Accepting new patients
Barton Healthcare System PastSince Jan 1, 1990 Accepting new patients
Barton Healthcare System PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320624000000",
    "number": "1609933910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 EMERALD BAY RD",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506207",
            "telephone_number": "530-543-5659",
            "fax_number": "530-541-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 SOUTH AVE",
            "address_2": "STE B",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507025",
            "telephone_number": "530-543-5623",
            "fax_number": "530-541-5738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "EVE-MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2011-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 18160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609933910",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609933910",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lake Tahoe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2011; 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.