Individual provider Active NPI

Elisa Tucker Bobbitt, AUD

  • Audiologist
  • Johns Creek, GA
National Provider Identifier
1235397092
Registry record updated Feb 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AUD003708 Issued in GA
Practice address
3005 Old Alabama Rd Ste 400
Johns Creek, GA 30022-1903
Phone
(470) 294-2116
NPI assigned
May 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AUD003708 GA Primary

Addresses

Primary practice location

3005 Old Alabama Rd Ste 400
Johns Creek, GA 30022-1903

Mailing address

3005 Old Alabama Rd Ste 400
Johns Creek, GA 30022-1903
Phone (470) 294-2116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240628001310 GA Practitioner - Qualified Audiologist 8426117797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3005 Old Alabama Rd
Suite 400
Johns Creek, GA 30022-1903
Phone (470) 294-2116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Newtown Hearing Center, LLC CurrentSince Mar 12, 2024 Accepting new patients

Locations

3005 Old Alabama Rd
Ste 400
Johns Creek, GA 30022
Phone (404) 309-0707

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.

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675555200000",
    "number": "1235397092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 OLD ALABAMA RD STE 400",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300221903",
            "telephone_number": "470-294-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 OLD ALABAMA RD STE 400",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300221903",
            "telephone_number": "470-294-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBBITT",
        "first_name": "ELISA",
        "middle_name": "TUCKER",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-29",
        "last_updated": "2023-02-05",
        "certification_date": "2023-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "GA",
            "license": "AUD003708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.