NPIMap

Organization Active NPI

Esrpa

  • Physician Assistant
  • Snellville, GA
National Provider Identifier
1568061000
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
ESRPA
Practice address
1717 Benhill Dr
Snellville, GA 30078-2595
Phone
(770) 689-8936
NPI assigned
Oct 24, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Authorized official

Name
Elissa StantonNPI 1134749930
Title
Provider
Phone
(770) 689-8936

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

1717 Benhill Dr
Snellville, GA 30078-2595

Mailing address

1717 Benhill Dr
Snellville, GA 30078-2595

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608595200000",
    "number": "1568061000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 BENHILL DR",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 BENHILL DR",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782595",
            "telephone_number": "770-689-8936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESRPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-24",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A",
        "authorized_official_last_name": "STANTON",
        "authorized_official_first_name": "ELISSA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "770-689-8936"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.