Individual provider Active NPI

Gina Rose McElfish, C.P.N.P.

  • Pediatric Nurse Practitioner
  • Yucca Valley, CA
National Provider Identifier
1861502247
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
C232435 Issued in CA
Practice address
57463 29 Palms Hwy
Suite 202
Yucca Valley, CA 92284-2925
Phone
(760) 365-0808
Fax
(760) 365-4545
NPI assigned
Aug 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X C232435 CA Primary

Addresses

Primary practice location

57463 29 Palms Hwy
Suite 202
Yucca Valley, CA 92284-2925

Mailing address

57570 San Andreas Rd
Yucca Valley, CA 92284-4185
Phone (760) 365-8806

Other identifiers 1

IdentifierTypeStateIssuer
NP0064540MedicaidCA

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)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
C232435CAMDPediatric Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861502247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57570 SAN ANDREAS RD",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922844185",
            "telephone_number": "760-365-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57463 29 PALMS HWY",
            "address_2": "SUITE 202",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922842925",
            "telephone_number": "760-365-0808",
            "fax_number": "760-365-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCELFISH",
        "first_name": "GINA",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "C.P.N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "C232435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0064540",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucca Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.