Individual provider Active NPI

Elizabeth Lahaie, MSN, BSN, RN

  • Pediatric Nurse Practitioner
  • Decatur, GA
National Provider Identifier
1124436944
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
274128 Issued in GA
Practice address
2165 N Decatur Rd FL 2
Decatur, GA 30033-5307
Phone
(404) 778-8504
NPI assigned
Jul 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 670896-1 NY
Neonatal Intensive Care Registered Nurse 163WN0002X RN9315157 FL
Student in an Organized Health Care Education/Training Program 390200000X NY
Pediatric Nurse Practitioner 363LP0200X 274128 GA Primary

Addresses

Primary practice location

2165 N Decatur Rd FL 2
Decatur, GA 30033-5307

Mailing address

200 N Highland Ave NE Unit 303
Atlanta, GA 30307-5624

Other practice location 1

370 W 30th St Apt 12D
New York, NY 10001-2771
Phone (904) 710-7274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20200129002913 GA Practitioner - Nurse Practitioner 6901232503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choa Multispecialty, LLCGroup PAC ID 7719126820, 35 clinicians

Practice addresses (Care Compare)

2015 Uppergate Dr NE
Atlanta, GA 30322-1014
Phone (404) 785-2000

Hospital & facility affiliations

  • Athur M Blank Hospital Hospital, Atlanta, GA, CCN 113300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
670896-1NYMDRegistered Nurse
RN9315157FLMDNeonatal Intensive Care Registered Nurse
274128GAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Choa Multispecialty, LLC Pediatrics CurrentSince Nov 1, 2019 Accepting new patients
Choa Hospital Based, LLC Pediatrics Current Accepting new patients
Egleston Pediatric Group Pediatrics Current Accepting new patients

Locations

1405 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 785-1112

2015 Upper Gate Dr NE
Atlanta, GA 30322
Phone (404) 778-2400

Organizations & group practices 3

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 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": "1406160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1124436944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N HIGHLAND AVE NE UNIT 303",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303075624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 N DECATUR RD FL 2",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335307",
            "telephone_number": "404-778-8504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "370 W 30th St Apt 12D",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100012771",
            "country_code": "US",
            "telephone_number": "904-710-7274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAHAIE",
        "first_name": "ELIZABETH",
        "credential": "MSN, BSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "670896-1",
            "primary": false
        },
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "FL",
            "license": "RN9315157",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "274128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.