Individual provider Active NPI

Elisa Drusky, PA-C

  • Medical Physician Assistant
  • Marietta, GA
National Provider Identifier
1386156503
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
9189 Issued in GA
Practice address
711 Canton Rd NE Ste 300
Marietta, GA 30060-8949
Phone
(678) 741-5000
Fax
(678) 819-4280
NPI assigned
Oct 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 50.005234RX OH
Medical Physician Assistant 363AM0700X 9189 GA Primary

Addresses

Primary practice location

711 Canton Rd NE Ste 300
Marietta, GA 30060-8949

Mailing address

711 Canton Rd NE Ste 300
Marietta, GA 30060-8949
Phone (678) 741-5000

Other practice location 1

2055 Hospital Dr Ste 325
Batavia, OH 45103-1986
Phone (513) 735-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9189GAMDDentist
50.005234RXOHMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1509062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1386156503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 CANTON RD NE STE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608949",
            "telephone_number": "678-741-5000",
            "fax_number": "678-819-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 CANTON RD NE STE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608949",
            "telephone_number": "678-741-5000",
            "fax_number": "678-819-4280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2055 Hospital Dr Ste 325",
            "address_purpose": "LOCATION",
            "city": "Batavia",
            "state": "OH",
            "postal_code": "451031986",
            "country_code": "US",
            "telephone_number": "513-735-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRUSKY",
        "first_name": "ELISA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-27",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.005234RX",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "9189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.