Active NPI
Elizabeth Alice Fries, PA-C
- Medical Physician Assistant
- Big Sur, CA
National Provider Identifier
1821095019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 51352
- Practice address
- 46896 Highway 1
Big Sur, CA 93920-9693 - Phone
- (831) 667-2580
- Fax
- (831) 667-0184
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA 1473 | CO | |
| Medical Physician Assistant | 363AM0700X | 51352 | CA | Primary |
Addresses
Primary practice location
46896 Highway 1
Big Sur, CA 93920-9693
Mailing address
46896 Highway 1
Big Sur, CA 93920-9693
Phone (831) 667-2580
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CMM70858F | Medicaid | CA |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1473 | CO | MD | Mental Health Counselor |
| 51352 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| PA 1473 | CO | MD | Medical Physician Assistant |
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": "1447113600000",
"number": "1821095019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46896 HIGHWAY 1",
"city": "BIG SUR",
"state": "CA",
"postal_code": "939209693",
"telephone_number": "831-667-2580",
"fax_number": "831-667-0184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "46896 HIGHWAY 1",
"city": "BIG SUR",
"state": "CA",
"postal_code": "939209693",
"telephone_number": "831-667-2580",
"fax_number": "831-667-0184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIES",
"first_name": "ELIZABETH",
"middle_name": "ALICE",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-01",
"last_updated": "2015-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CO",
"license": "PA 1473",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "51352",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CMM70858F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Big Sur, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.