Individual provider Active NPI

Elizabeth Sijo Georgin, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1093396087
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2022045065 Issued in MO
Practice address
7419 Watson Rd
Saint Louis, MO 63119-4415
Phone
(314) 400-3360
Fax
(314) 400-3363
NPI assigned
Apr 20, 2021
Last updated
Sep 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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 2022045065 MO Primary

Addresses

Primary practice location

7419 Watson Rd
Saint Louis, MO 63119-4415

Mailing address

PO Box 419052
Saint Louis, MO 63141-9052
Phone (314) 851-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20240125000917 MO Practitioner - Nurse Practitioner 3577964055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
American Multispecialty Group IncGroup PAC ID 1658365572, 118 clinicians

Practice addresses (Care Compare)

13303 Tesson Ferry Rd
Suite 150
Saint Louis, MO 63128-4066
Phone (314) 842-5239

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2022045065MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Multispecialty Group Inc. Family CurrentSince Jan 29, 2024 Accepting new patients

Locations

1475 Kisker Rd
Ste 230
Saint Charles, MO 63304
Phone (636) 939-5000

13303 Tesson Ferry Rd
Ste 150
Saint Louis, MO 63128
Phone (314) 842-4744

7419 Watson Rd
Saint Louis, MO 63119
Phone (314) 400-3360

9930 Watson Rd
Saint Louis, MO 63126
Phone (314) 984-8827

Interoperability endpoints

  • Direct secure messaging: elizabeth.georgin.p1@direct.essehealth.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1093396087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419052",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631419052",
            "telephone_number": "314-851-1000",
            "fax_number": "314-851-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7419 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631194415",
            "telephone_number": "314-400-3360",
            "fax_number": "314-400-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGIN",
        "first_name": "ELIZABETH",
        "middle_name": "SIJO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-20",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2022045065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.