Elizabeth Brosnahan Ferris, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2018-0015 Issued in NM

Practice address

4420 Irving Blvd NW
Albuquerque, NM 87114-5915

Phone

(505) 727-6300

Fax

(505) 727-9588

NPI assigned

Oct 30, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Elizabeth Leigh Brosnahan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Southwest Medical Associates, LLC

  • General Practice Physician
  • Albuquerque, NM
  • NPI 1164491072
  NPD (past)

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1821460734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 IRVING BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145915",
            "telephone_number": "505-727-6300",
            "fax_number": "505-727-9588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 IRVING BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145915",
            "telephone_number": "505-727-6300",
            "fax_number": "505-727-9588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16528 E Desmet Ct",
            "address_purpose": "LOCATION",
            "city": "Spokane Valley",
            "state": "WA",
            "postal_code": "992163522",
            "country_code": "US",
            "telephone_number": "509-944-8910",
            "fax_number": "509-227-7070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "914 W Carlisle Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992053309",
            "country_code": "US",
            "telephone_number": "509-325-0393",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16528 E Desmet Ct",
            "address_purpose": "LOCATION",
            "city": "Spokane Valley",
            "state": "WA",
            "postal_code": "992163522",
            "country_code": "US",
            "telephone_number": "509-944-8910",
            "fax_number": "509-227-7070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERRIS",
        "first_name": "ELIZABETH",
        "middle_name": "BROSNAHAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-30",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09488",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60608545",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2018-0015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82802548",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "BROSNAHAN",
            "middle_name": "LEIGH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shane Ferrell
• Maria Fernanda Ferrer-Hernandez, LPCC
• Thomas Ferrer
• Linda Tinker Ferretti, AUD
• Mark Ferriegel, LPCC
• Daniel Scott Ferryman
• Mellisa Fether
• Jean Fetner, OT
• Elesha Kay Fetrow, LMHC. NCC
• Jessica M. Fett, PSYD

• Physician Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; 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.