Individual provider Active NPI

Susan Elaine Eldred, NP

  • Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1770679128
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN134366 Issued in GA
Practice address
1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Phone
(678) 312-3273
Fax
(678) 312-3282
NPI assigned
Oct 5, 2006
Last updated
Apr 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN134366 GA Primary

Addresses

Primary practice location

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694

Mailing address

PO Box 1170
Lawrenceville, GA 30046-1170
Phone (678) 312-5525

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
I20070307000567 GA Practitioner - Nurse Practitioner 4587767850 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Professional Services LLCGroup PAC ID 0840291944, 423 clinicians

Practice addresses (Care Compare)

1000 Medical Ctr Blvd
Lawrenceville, GA 30046-7694
Phone (770) 255-7500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.79 of 100Reported as group
Quality
98.74
Improvement activities
40
Cost
83.11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gwinnett Pathology Assoc PC Current Accepting new patients
North Atlanta Professional Services LLC CurrentSince Jan 13, 2023 Accepting new patients
Gwinnett Physician Group, LLC CurrentSince Jan 1, 2010 Accepting new patients
Gwinnett Medical Group, Inc CurrentSince Apr 19, 2020 Accepting new patients
Northside Hospital, Inc. CurrentSince Jan 1, 2015 Accepting new patients
Northside Hospital, Inc. Current Accepting new patients

Locations

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1770679128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1170",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300461170",
            "telephone_number": "678-312-5525",
            "fax_number": "770-339-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467694",
            "telephone_number": "678-312-3273",
            "fax_number": "678-312-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDRED",
        "first_name": "SUSAN",
        "middle_name": "ELAINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN134366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.