Active NPI
Jennifer Ann Ehmann, MD
- Pediatrics Physician
- South Lake Tahoe, CA
National Provider Identifier
1710984075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A67687
- Practice address
- 2201 South Ave
South Lake Tahoe, CA 96150-7025 - Phone
- (530) 543-5623
- Fax
- (530) 541-5738
- NPI assigned
- Jul 1, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 11072 | NV | |
| Pediatrics Physician | 208000000X | A67687 | CA | Primary |
Addresses
Primary practice location
2201 South Ave
South Lake Tahoe, CA 96150-7025
Mailing address
1111 Emerald Bay Rd
South Lake Tahoe, CA 96150-6207
Phone (530) 543-5659
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A67687 | CA | MD | Pediatrics Physician |
| 11072 | NV | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Speicher Medical GRP | Pediatrics | Past | Accepting new patients |
| Washoe Barton Medical Clinic a Nevada Nonprofit Corporation | Past | Accepting new patients | |
| Barton Healthcare System | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- South Lake Tahoe, CA
- NPI 1235196015
-
- Home Health Agency
- South Lake Tahoe, CA
- NPI 1356348890
-
- Pediatrics Physician
- Reno, NV
- NPI 1194970921
-
- Critical Access Hospital
- Gardnerville, NV
- NPI 1396799102
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441152000000",
"number": "1710984075",
"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",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961507025",
"telephone_number": "530-543-5623",
"fax_number": "530-541-5738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EHMANN",
"first_name": "JENNIFER",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-01",
"last_updated": "2015-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NV",
"license": "11072",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A67687",
"primary": true
}
],
"identifiers": [],
"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 Sep 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.