Individual provider Active NPI

Mary-Ellis Ford Arnold, R.N., A.N.P.

  • Adult Health Nurse Practitioner
  • Berkeley, CA
National Provider Identifier
1619018322
Registry record updated Feb 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
16989 Issued in CA
Practice address
2001 Dwight Way
Berkeley, CA 94704-2608
Phone
(510) 204-4666
NPI assigned
Feb 8, 2007
Last updated
Feb 1, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2011

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 16989 CA Primary

Addresses

Primary practice location

2001 Dwight Way
Berkeley, CA 94704-2608

Mailing address

2001 Dwight Way
Berkeley, CA 94704-2608
Phone (510) 204-4444

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
Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296518400000",
    "number": "1619018322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 DWIGHT WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947042608",
            "telephone_number": "510-204-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 DWIGHT WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947042608",
            "telephone_number": "510-204-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "MARY-ELLIS",
        "middle_name": "FORD",
        "name_prefix": "Ms.",
        "credential": "R.N., A.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2011-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "16989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.