Elisabeth Jacqueline Guillemin

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PAT-9109926 Issued in FL

Practice address

6573 A1A S
Saint Augustine, FL 32080-7504

Phone

(904) 342-7363

NPI assigned

Dec 12, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2635/brand/1/csg/1/fhir/r4

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

• Family Practice Associates of Taos

  • Family Medicine Physician
  • Taos, NM
  • NPI 1881619864
  Medicare reassignment
• Family Practice Associates of Taos

  • Physiological Laboratory
  • Taos, NM
  • NPI 1407195233
  NPD
• Crescent Beach Care LLC

  • Family Medicine Physician
  • St Augustine, FL
  • NPI 1033451380
  NPD (past)

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1841734779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 GROVE AVE",
            "address_2": "APT A",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320843251",
            "telephone_number": "575-770-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6573 A1A S",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320807504",
            "telephone_number": "904-342-7363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLEMIN",
        "first_name": "ELISABETH",
        "middle_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-12",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PAT-9109926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas John Guardia, DPT PT
• Ashley Jarriel Gucwa, PA-C
• Regan Marie Guess, PT, DPT
• Jennifer Guettler-Henderson
• Jessica Mackenzie Guididas, LCSW
• Priscilla Lee Gulliver, M.S.,
• Debora Lynn Gumble
• Selin Gunaydin
• Andrew J Gunn, M.D.
• Ryan Gutierrez, D.C.

• Medical Physician Assistant in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; 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.

Verify at the official NPI Registry.