Individual provider Active NPI

Elizabeth Coble Pulliam

  • Certified Registered Nurse Anesthetist
  • Greensboro, NC
National Provider Identifier
1679124580
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
129110 Issued in NC
Practice address
2400 W Friendly Ave
Greensboro, NC 27403-1109
Phone
(336) 832-1000
NPI assigned
Sep 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209028942 IL
Certified Registered Nurse Anesthetist 367500000X 129110 NC Primary

Addresses

Primary practice location

2400 W Friendly Ave
Greensboro, NC 27403-1109

Mailing address

2400 W Friendly Ave
Greensboro, NC 27403-1109

Other practice location 1

3301 Broadway St
Quincy, IL 62301-3713
Phone (217) 277-4090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191118001246 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890127526 Reassigns benefits to 4 organizations
I20231212003706 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890127526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Moses H Cone Memorial Hospital Operating CorporationGroup PAC ID 6204744600, 724 clinicians
Medstream Anesthesia PLLCGroup PAC ID 7416198049, 571 clinicians

Practice addresses (Care Compare)

1236 Huffman Mill Rd
Suite 130
Burlington, NC 27215-8700
Phone (336) 438-1060

1240 Huffman Mill Rd
Burlington, NC 27215-8700
Phone (336) 538-7000

1248 Huffman Mill Rd
Suite 101
Burlington, NC 27215-8700
Phone (336) 275-0927

364 White Oak St
Asheboro, NC 27203-5434
Phone (336) 625-5151

501 N Elam Ave
Greensboro, NC 27403-1118
Phone (336) 832-1000

509 E N Elam Ave
FL 3
Greensboro, NC 27403-1118
Phone (336) 832-1970

Hospital & facility affiliations

  • Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091
  • Alamance Regional Medical Center Hospital, Burlington, NC, CCN 340070
  • Randolph Hospital Hospital, Asheboro, NC, CCN 340123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
209028942ILMDCertified Registered Nurse Anesthetist
129110NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of North Carolina, PLLC CurrentSince Oct 1, 2023 Accepting new patients
American Anesthesiology of North Carolina, PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2023 Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 25, 2024 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Jan 1, 2024 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Jan 1, 2024 Accepting new patients
Wake Forest University Health Sciences CurrentSince Aug 1, 2024 Accepting new patients
The Moses H. Cone Memorial Hospital Operating Corporation CurrentSince Feb 1, 2023 Accepting new patients

Locations

3301 Broadway St
Quincy, IL 62301
Phone (217) 277-4070

1025 Maine St
Quincy, IL 62301
Phone 21722265503163

364 White Oak St
Asheboro, NC 27203
Phone (336) 625-5151

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

2400 W Friendly Ave
Greensboro, NC 27403
Phone (336) 832-1100

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

801 Green Valley Rd
Greensboro, NC 27408
Phone (336) 282-4840

3940 Arrowhead Blvd
Ste 130
Mebane, NC 27302
Phone (919) 568-7400

830 Rockford St
Mount Airy, NC 27030
Phone (336) 719-7000

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705

618 S Main St
Reidsville, NC 27320
Phone (336) 832-7965

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Organizations & group practices 7

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 3

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": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1679124580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 W FRIENDLY AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W FRIENDLY AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031109",
            "telephone_number": "336-832-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3301 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "IL",
            "postal_code": "623013713",
            "country_code": "US",
            "telephone_number": "217-277-4090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PULLIAM",
        "first_name": "ELIZABETH",
        "middle_name": "COBLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209028942",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "129110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.