Elizabeth Edacheril Poulose

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

5011182 Issued in NC

Practice address

1041 Kirkpatrick Rd Ste 100
Burlington, NC 27215-8066

Phone

(336) 538-0565

NPI assigned

Nov 5, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physicians Eldercare PAGroup PAC ID 0648184705, 236 clinicians

Curana Health of North Carolina PLLCGroup PAC ID 1850774332, 274 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: epoulose1679173@direct.novanthealth.org

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.

• Curana Health of North Carolina PLLC

  • Internal Medicine Physician
  • Durham, NC
  • NPI 1770217176
  Medicare reassignment Care Compare group NPD
• Physicians Eldercare PA

  • General Practice Physician
  • Durham, NC
  • NPI 1023083268
  Medicare reassignment Care Compare group NPD
• Cornerstone Medical Center, PA

  • Family Medicine Physician
  • Burlington, NC
  • NPI 1548233182
  NPD

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

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1205304409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 KIRKPATRICK RD STE 100",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158066",
            "telephone_number": "336-538-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 KIRKPATRICK RD STE 100",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158066",
            "telephone_number": "336-538-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULOSE",
        "first_name": "ELIZABETH",
        "middle_name": "EDACHERIL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-05",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "5011182",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5011182",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER APPROVAL TO PRACTICE",
            "identifier": "5011182",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Poole Glowbal LLC
• Cynthia L. Porfilio, MPT
• William Louis Porfilio, MD
• Zachary Potter, M.D.
• Amanda Marie Poulin, CPNP-PC
• Kia Sarika Powers, PH.D
• Melanie Powers, LCMHCA
• Preferred Primary Care, PLLC
• Premier Home Health Care Services, Inc
• Premier Home Health Care Services, Inc.

• Primary Care Nurse Practitioner in Burlington, NC
• Providers in Burlington, NC by specialty
• Primary Care Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.