Active NPI
Elaine Gail Stanifer, D.P.M.
- Podiatrist
- Santa Rosa, CA
National Provider Identifier
1881848935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- E3913
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| E3913 | CA | MD | Foot 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.