Individual provider Active NPI

Elisabeth Pettit Berman, N.P.

  • Adult Health Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1689059180
Registry record updated Jul 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN114017 Issued in GA
Practice address
59 Executive Park S
Atlanta, GA 30329-2208
Phone
(404) 778-7000
NPI assigned
Jul 25, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN114017 GA Primary

Addresses

Primary practice location

59 Executive Park S
Atlanta, GA 30329-2208

Mailing address

59 Executive Park S
Atlanta, GA 30329-2208
Phone (404) 778-7000

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
I20151008002699 GA Practitioner - Nurse Practitioner 0547578676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN114017GAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Oct 31, 2015 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

59 Executive Park South NE
Atlanta, GA 30329
Phone (404) 778-6330

Interoperability endpoints

  • Direct secure messaging: eberman34060@direct.emory.org

Organizations & group practices 2

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 7

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": "1437782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437782400000",
    "number": "1689059180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 EXECUTIVE PARK S",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292208",
            "telephone_number": "404-778-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 EXECUTIVE PARK S",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292208",
            "telephone_number": "404-778-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "ELISABETH",
        "middle_name": "PETTIT",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-25",
        "last_updated": "2015-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN114017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.