Individual provider Active NPI

Elizabeth Chandler Harris, PA-C

  • Physician Assistant
  • Lawrenceville, GA
National Provider Identifier
1629556832
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
008862 Issued in GA
Practice address
301 Phiip Blvd
Suite a
Lawrenceville, GA 30046-8746
Phone
(770) 822-5560
Fax
(770) 822-4989
NPI assigned
Jul 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 008862 GA Primary

Addresses

Primary practice location

301 Phiip Blvd
Suite a
Lawrenceville, GA 30046-8746

Mailing address

1001 Summit Blvd Ste 200
Brookhaven, GA 30319-6410
Phone (770) 989-1668

Other practice location 1

1600 Medical Way Ste 270
Snellville, GA 30078-2209
Phone (770) 972-4780

Other identifiers 1

IdentifierTypeStateIssuer
003208377AMedicaidGA

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
I20181022003100 GA Practitioner - Physician Assistant 6608129671 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercer University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aga Professional Services LLCGroup PAC ID 3870768997, 175 clinicians

Practice addresses (Care Compare)

488 Kennesaw Ave NW
Suite 200
Marietta, GA 30060-9409
Phone (770) 427-3075

550 Peachtree St NE
Suite 1600
Atlanta, GA 30308-2246
Phone (404) 881-1094

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.39 of 100Reported as group
Quality
44.91
Promoting interoperability
98
Improvement activities
40
Cost
71.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008862GAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: elizabeth.harris@ud.eclinicaldirectplus.com

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": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1629556832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 SUMMIT BLVD STE 200",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303196410",
            "telephone_number": "770-989-1668",
            "fax_number": "678-388-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PHIIP BLVD",
            "address_2": "SUITE A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468746",
            "telephone_number": "770-822-5560",
            "fax_number": "770-822-4989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Medical Way Ste 270",
            "address_purpose": "LOCATION",
            "city": "Snellville",
            "state": "GA",
            "postal_code": "300782209",
            "country_code": "US",
            "telephone_number": "770-972-4780",
            "fax_number": "770-972-2371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ELIZABETH",
        "middle_name": "CHANDLER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "008862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003208377A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.