Elaine Nussbaum, APN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN222173 Issued in GA

Practice address

455 S Main St Ste 103
Hinesville, GA 31313-4354

Phone

(912) 876-6868

Fax

(912) 876-6566

NPI assigned

Feb 9, 2006

Last updated

Mar 5, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Pediatric Associates of Savannah, P.C.

  • Pediatrics Physician
  • Savannah, GA
  • NPI 1508850231
  NPD (past)
• Pediatric Associates of Savannah, P.C.

  • Pediatrics Physician
  • Savannah, GA
  • NPI 1932252244
  NPD (past)
• Practice Associates,Inc

  • Physician Assistant
  • Morristown, NJ
  • NPI 1699733907
  NPD (past)
• Specialty Care of Practice Associates,PA

  • Specialist
  • Morristown, NJ
  • NPI 1215985908
  NPD (past)

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1346213378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 S MAIN ST STE 103",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134354",
            "telephone_number": "912-876-6868",
            "fax_number": "912-876-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 S MAIN ST STE 103",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134354",
            "telephone_number": "912-876-6868",
            "fax_number": "912-876-6566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 Waters Ave",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046702",
            "country_code": "US",
            "telephone_number": "912-355-2462",
            "fax_number": "912-353-1836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUSSBAUM",
        "first_name": "ELAINE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NN06481700",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN222173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003124416A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Portal",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Hinesville",
            "address_1": "455 S Main St Ste 103",
            "city": "Hinesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "313134354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emily Vest Norman, OTR/L
• Steven William Norman, LPC
• Nicole Null, MA/ST
• Nicole Ilene Numkena
• David M. Nussbaum, D. O.
• Bethany Olivia O'Bryan
• T'Challa O'Bryant, LPC
• Kelly O'Keefe-Watson, P.A.
• Christopher O'Malley, PTA
• Jada O'Neal

• Pediatric Nurse Practitioner in Hinesville, GA
• Providers in Hinesville, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.