Individual provider Active NPI

Casey Jones Elliott, FNP

  • Family Nurse Practitioner
  • Dacula, GA
National Provider Identifier
1427508043
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN215190 Issued in GA
Practice address
852 Dacula Rd
Dacula, GA 30019-3185
Phone
(770) 848-9380
NPI assigned
Oct 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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 RN215190 GA Primary

Addresses

Primary practice location

852 Dacula Rd
Dacula, GA 30019-3185

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

400 Peachtree Industrial Blvd
Suwanee, GA 30024-6989
Phone (770) 831-3857

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address celliott133458@nghs.gadirect.net Direct

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
I20161017000274 GA Practitioner - Nurse Practitioner 4880982339 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Georgia Physicians Group Urgent Care LLCGroup PAC ID 3274535687, 62 clinicians

Practice addresses (Care Compare)

852 Dacula Rd
Dacula, GA 30019-3185
Phone (770) 848-9381

Hospital & facility affiliations

  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN215190GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Urgent Care LLC CurrentSince Feb 7, 2022 Accepting new patients
Northeast Georgia Physicians Group Inc CurrentSince Apr 1, 2025 Accepting new patients
TLC of Georgia LLC Family CurrentSince Oct 16, 2016 Accepting new patients

Locations

1515 River Pl
Ste 100
Braselton, GA 30517
Phone (770) 848-6195

852 Dacula Rd
Dacula, GA 30019
Phone (770) 848-9360

455 Nathan Dean Blvd
Dallas, GA 30132
Phone (770) 443-8776

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

1685 Old Pendergrass Rd
Jefferson, GA 30549
Phone (706) 387-7620

3600 Dallas Hwy SW
Marietta, GA 30064
Phone (770) 420-9170

400 Peachtree Industrial Blvd
Suwanee, GA 30024
Phone (770) 831-3857

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1427508043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "852 DACULA RD",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300193185",
            "telephone_number": "770-848-9380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Peachtree Industrial Blvd",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300246989",
            "country_code": "US",
            "telephone_number": "770-831-3857",
            "fax_number": "770-831-3858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "CASEY",
        "middle_name": "JONES",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-06",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN215190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "celliott133458@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "852 Dacula Rd",
            "city": "Dacula",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300193185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

Verify at the official NPI Registry.