Individual provider Active NPI

Elisabeth Conforti, NP

  • Family Nurse Practitioner
  • Macon, GA
National Provider Identifier
1407273337
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
103622 Issued in GA
Practice address
3400 Riverside Dr
Macon, GA 31210-2513
Phone
(784) 745-6004
Fax
(478) 474-6769
NPI assigned
Mar 28, 2014
Last updated
Sep 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 103622 GA Primary

Addresses

Primary practice location

3400 Riverside Dr
Macon, GA 31210-2513

Mailing address

3400 Riverside Dr
Macon, GA 31210-2513
Phone (784) 745-6004

Other practice location 1

1205 Russell Pkwy
Warner Robins, GA 31088-5538
Phone (478) 302-5729

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
I20151113000839 GA Practitioner - Nurse Practitioner 7517277924 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
103622GAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical Center of Central Georgia Inc CurrentSince Sep 22, 2019 Accepting new patients
The Medical Center of Central Georgia Inc. Current Accepting new patients
Peachtree Immediate Care FP, LLC PastSince Sep 18, 2024 Accepting new patients
Hariyebbe C. Jayaraj, MD, PC PastSince Jun 9, 2012 Accepting new patients

Locations

3400 Riverside Dr
Macon, GA 31210
Phone (478) 474-5600

Interoperability endpoints

  • Direct secure messaging: econforti433601@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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": "1395964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1407273337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 RIVERSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102513",
            "telephone_number": "784-745-6004",
            "fax_number": "478-474-6769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 RIVERSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102513",
            "telephone_number": "784-745-6004",
            "fax_number": "478-474-6769"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1205 Russell Pkwy",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310885538",
            "country_code": "US",
            "telephone_number": "478-302-5729",
            "fax_number": "478-302-5731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONFORTI",
        "first_name": "ELISABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-28",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "103622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.