Individual provider Active NPI

Lonny David Elson, NP

  • Primary Care Nurse Practitioner
  • Flagstaff, AZ
National Provider Identifier
1912192048
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
293605 Issued in AZ
Practice address
1016 W University Ave Ste 206
Flagstaff, AZ 86001-2996
Phone
(928) 266-1530
Fax
(928) 438-6637
NPI assigned
Sep 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 293605 AZ Primary

Addresses

Primary practice location

1016 W University Ave Ste 206
Flagstaff, AZ 86001-2996

Mailing address

1016 W University Ave Ste 206
Flagstaff, AZ 86001-2996
Phone (928) 266-1530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20230816001357 AZ Practitioner - Nurse Practitioner 4183086606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1016 W University Ave
Suite 206
Flagstaff, AZ 86001-2996
Phone (928) 266-1530

Hospital & facility affiliations

  • Flagstaff Medical Center Hospital, Flagstaff, AZ, CCN 030023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
293605AZMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Pasternacki Family Healthcare Current Accepting new patients
Lonny Elson Family Healthcare CurrentSince Jul 8, 2023 Accepting new patients

Locations

1016 W University Ave
Ste 206
Flagstaff, AZ 86001
Phone (928) 226-1530

1016 W University Ave
Ste 101206
Flagstaff, AZ 86001

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1912192048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 W UNIVERSITY AVE STE 206",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860012996",
            "telephone_number": "928-266-1530",
            "fax_number": "928-438-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 W UNIVERSITY AVE STE 206",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860012996",
            "telephone_number": "928-266-1530",
            "fax_number": "928-438-6637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSON",
        "first_name": "LONNY",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-11",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "293605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.