Individual provider Active NPI

Meseret Amare, LVN

  • Licensed Vocational Nurse
  • Elk Grove, CA
National Provider Identifier
1629768965
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
713145 Issued in CA
Practice address
5904 Isaac Way
Elk Grove, CA 95757-5954
Phone
(916) 743-2006
NPI assigned
May 10, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 713145 CA Primary

Addresses

Primary practice location

5904 Isaac Way
Elk Grove, CA 95757-5954

Mailing address

5904 Isaac Way
Elk Grove, CA 95757-5954
Phone (916) 743-2006

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

LicenseStateTypeSpecialty
713145CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1629768965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5904 ISAAC WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957575954",
            "telephone_number": "916-743-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5904 ISAAC WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957575954",
            "telephone_number": "916-743-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMARE",
        "first_name": "MESERET",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "713145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; 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.