NPIMap

Individual provider Active NPI

Elizabeth C Vevera, M.D.

  • Family Medicine Physician
  • Cumming, GA
National Provider Identifier
1114943388
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
041990 Issued in GA
Practice address
1505 Northside Blvd
Ste 4400
Cumming, GA 30041-7623
Phone
(678) 513-8800
Fax
(678) 513-8500
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 041990 GA Primary

Addresses

Primary practice location

1505 Northside Blvd
Ste 4400
Cumming, GA 30041-7623

Mailing address

1505 Northside Blvd
Ste 4400
Cumming, GA 30041-7623
Phone (678) 513-8800

Other identifiers 1

IdentifierTypeStateIssuer
003149913AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elizabethvevera@pnfm.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060104000798 GA Practitioner - Family Practice 0244253318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
Perimeter Professional Services, LLCGroup PAC ID 9032337423, 21 clinicians

Practice addresses (Care Compare)

100 Mountain View Dr
Suite 100
Cumming, GA 30040-2434
Phone (770) 889-2163

2600 Compass Rd
Glenview, IL 60026-8001

3400 Old Milton Pkwy
Alpharetta, GA 30005-4417
Phone (770) 664-8898

488 N Main St
Suite 204
Alpharetta, GA 30009-2386
Phone (770) 619-5801

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
041990GAMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: elizabethvevera@pnfm.allscriptsdirect.net

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

Hospital & facility affiliations 5

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1114943388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 NORTHSIDE BLVD",
            "address_2": "STE 4400",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417623",
            "telephone_number": "678-513-8800",
            "fax_number": "678-513-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 NORTHSIDE BLVD",
            "address_2": "STE 4400",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417623",
            "telephone_number": "678-513-8800",
            "fax_number": "678-513-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEVERA",
        "first_name": "ELIZABETH",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "041990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003149913A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elizabethvevera@pnfm.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "1505 Northside Blvd",
            "address_2": "Ste 4400",
            "city": "Cumming",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300417623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.