Individual provider Active NPI

Elizabeth A Ehrhardt, MD

  • Pediatrics Physician
  • Pueblo, CO
National Provider Identifier
1689655409
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
37792 Issued in CO
Practice address
1910 Lake Ave
Pueblo, CO 81004-3322
Phone
(719) 583-2330
Fax
(719) 583-2670
NPI assigned
Nov 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 37792 CO Primary

Addresses

Primary practice location

1910 Lake Ave
Pueblo, CO 81004-3322

Mailing address

1910 Lake Ave
Pueblo, CO 81004-3322
Phone (719) 583-2330

Other identifiers 1

IdentifierTypeStateIssuer
49788817MedicaidCO

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37792COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stepping Stones Pediatrics LLC Pediatrics Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1689655409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 LAKE AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043322",
            "telephone_number": "719-583-2330",
            "fax_number": "719-583-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 LAKE AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043322",
            "telephone_number": "719-583-2330",
            "fax_number": "719-583-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHRHARDT",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-09",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "37792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49788817",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.