Individual provider Active NPI

Elaine Gail Stanifer, D.P.M.

  • Podiatrist
  • Santa Rosa, CA
National Provider Identifier
1881848935
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E3913 Issued in CA
Practice address
3841 Brickway Blvd
Santa Rosa, CA 95403-8226
Phone
(707) 569-2300
Fax
(707) 569-2383
NPI assigned
Nov 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E3913 CA Primary
Foot Surgery Podiatrist 213ES0131X E3913 CA

Addresses

Primary practice location

3841 Brickway Blvd
Santa Rosa, CA 95403-8226

Mailing address

3841 Brickway Boulevard
Santa Rosa, CA 95403-8210
Phone (707) 569-2300

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

State licenses

LicenseStateTypeSpecialty
E3913CAMDFoot Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1226620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1881848935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 BRICKWAY BOULEVARD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954038210",
            "telephone_number": "707-569-2300",
            "fax_number": "707-569-2383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3841 BRICKWAY BLVD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954038226",
            "telephone_number": "707-569-2300",
            "fax_number": "707-569-2383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANIFER",
        "first_name": "ELAINE",
        "middle_name": "GAIL",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-14",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3913",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CA",
            "license": "E3913",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.