Individual provider Active NPI

Emily Ann Ferrell Pope, NP

  • Pediatric Nurse Practitioner
  • Santa Rosa, CA
National Provider Identifier
1730290834
Registry record updated Nov 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
NP95003418 Issued in CA
Practice address
500 Doyle Park Dr
Suite 100
Santa Rosa, CA 95405-4558
Phone
(707) 544-6090
Fax
(707) 544-2389
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APN11759 TN
Registered Nurse 163W00000X RN639980 CA
Pediatric Nurse Practitioner 363LP0200X NP95003418 CA Primary

Addresses

Primary practice location

500 Doyle Park Dr
Suite 100
Santa Rosa, CA 95405-4558

Mailing address

500 Doyle Park Dr
Suite 100
Santa Rosa, CA 95405-4558
Phone (707) 544-6090

Other names 1

  • Emily Ann Ferrell Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151211001890 CA Practitioner - Nurse Practitioner 2860793056 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN639980CAMDRegistered Nurse
NP95003418CAMDPediatric Nurse Practitioner
APN11759TNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Nov 20, 2015 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Nov 20, 2015 Accepting new patients
Providence Medical Foundation Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 400
Anaheim, CA 92805

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Interoperability endpoints

  • Direct secure messaging: epope1647962@oc.providencedirect.org

Organizations & group practices 5

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448409600000",
    "number": "1730290834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR",
            "address_2": "SUITE 100",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054558",
            "telephone_number": "707-544-6090",
            "fax_number": "707-544-2389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR",
            "address_2": "SUITE 100",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054558",
            "telephone_number": "707-544-6090",
            "fax_number": "707-544-2389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPE",
        "first_name": "EMILY",
        "middle_name": "ANN FERRELL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "APN11759",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN639980",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "NP95003418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "FERRELL",
            "middle_name": "ANN",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.