Active NPI
Elizabeth A Sommers, PAC
- Physician Assistant
- Green Bay, WI
National Provider Identifier
1972735363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2487
- Practice address
- 1970 S Ridge Rd
Green Bay, WI 54304 - Phone
- (920) 430-4888
- Fax
- (920) 430-4889
- NPI assigned
- Aug 18, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 2487-23 | WI | |
| Physician Assistant | 363A00000X | 2487 | WI | Primary |
Addresses
Primary practice location
1970 S Ridge Rd
Green Bay, WI 54304
Mailing address
PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222
Other practice location 1
2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5380
Other practice location 2
820 Arbutus Ave
Oconto, WI 54153-2004
Phone (920) 835-1100
Other practice location 3
744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 433-3500
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2487 | WI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568246400000",
"number": "1972735363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 22487",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543052487",
"telephone_number": "920-445-7222",
"fax_number": "920-445-7289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1970 S RIDGE RD",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "54304",
"telephone_number": "920-430-4888",
"fax_number": "920-430-4889"
}
],
"practiceLocations": [
{
"address_1": "2820 Roosevelt Rd",
"address_purpose": "LOCATION",
"city": "Marinette",
"state": "WI",
"postal_code": "541433834",
"country_code": "US",
"telephone_number": "715-735-5380",
"fax_number": "715-735-5233",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "820 Arbutus Ave",
"address_purpose": "LOCATION",
"city": "Oconto",
"state": "WI",
"postal_code": "541532004",
"country_code": "US",
"telephone_number": "920-835-1100",
"fax_number": "920-835-1099",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "744 S Webster Ave",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543013505",
"country_code": "US",
"telephone_number": "920-433-3500",
"fax_number": "920-445-7301",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SOMMERS",
"first_name": "ELIZABETH",
"middle_name": "A",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-18",
"last_updated": "2019-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "WI",
"license": "2487-23",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "2487",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.