Elaine Joy-Peterson Maloney, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704159600 Issued in MI

Practice address

550 Munson Ave
Traverse City, MI 49686-3580

Phone

(231) 935-8540

Fax

(231) 935-8544

NPI assigned

Oct 26, 2006

Last updated

Jan 15, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1619052081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MUNSON AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863580",
            "telephone_number": "231-935-8540",
            "fax_number": "231-935-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 MUNSON AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863580",
            "telephone_number": "231-935-8540",
            "fax_number": "231-935-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONEY",
        "first_name": "ELAINE",
        "middle_name": "JOY-PETERSON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704159600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "EL159600",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104307472",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Thomas Majszak, LMSW, CAADC
• Making Meaning LLC
• Kaitlyn Marie Malaski, DPT, NCS
• Megan Kathleen Malaski
• Abdul M Malik, M.D.
• Patrick Maloney, PHARMD
• Management & Behavior Consultants, P. C.
• Debra A Mandenberg
• Matthew Charles Mandeville, DDS
• Charity Manke, MA, LLP

• Nurse Practitioner in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; 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.