Individual provider Active NPI

Elizabeth A. Ross, RN, MSN, FNP-C

  • Family Nurse Practitioner
  • Stockton, CA
National Provider Identifier
1871598896
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
333379 Issued in CA
Practice address
77 W March LN Ste a
Stockton, CA 95207-5724
Phone
(209) 477-5552
Fax
(209) 477-5553
NPI assigned
Jun 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 333379 CA Primary

Addresses

Primary practice location

77 W March LN Ste a
Stockton, CA 95207-5724

Mailing address

77 W March LN Ste a
Stockton, CA 95207-5724
Phone (209) 477-5552

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
I20050609001168 CA Practitioner - Nurse Practitioner 8820031891 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
8746CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
HT Family Physicians, Inc. CurrentSince May 2, 2023 Accepting new patients

Locations

999 S Fairmont Ave
Ste 215
Lodi, CA 95240
Phone (209) 333-8510

1801 E March Ln
Ste A170
Stockton, CA 95210
Phone (209) 477-5552

77 W March Ln
Ste A
Stockton, CA 95207
Phone (209) 477-5552

Interoperability endpoints

  • Direct secure messaging: eross55952@hpmg.direct-ci.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1871598896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 W MARCH LN STE A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075724",
            "telephone_number": "209-477-5552",
            "fax_number": "209-477-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W MARCH LN STE A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075724",
            "telephone_number": "209-477-5552",
            "fax_number": "209-477-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "ELIZABETH",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "RN, MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "333379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.