Individual provider Active NPI

Laurie Ellen Nelson, M.S.

  • Audiologist
  • Marietta, GA
National Provider Identifier
1811093784
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1814 Issued in GA
Practice address
707 Whitlock Ave SW Ste A36
Marietta, GA 30064-4654
Phone
(770) 427-3033
Fax
(770) 427-3035
NPI assigned
Sep 16, 2006
Last updated
Feb 20, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1814 GA Primary

Addresses

Primary practice location

707 Whitlock Ave SW Ste A36
Marietta, GA 30064-4654

Mailing address

707 Whitlock Ave SW Ste A36
Marietta, GA 30064-4654
Phone (770) 427-3033

Other identifiers 1

IdentifierTypeStateIssuer
000817847EMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061204000136 GA Practitioner - Qualified Audiologist 7214936129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Laurie Nelson, IncGroup PAC ID 4486976867, 3 clinicians

Practice addresses (Care Compare)

707 Whitlock Ave
Suite a 36
Marietta, GA 30064-3000
Phone (770) 427-3033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1814GAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Laurie Nelson, Inc. Audiologist CurrentSince May 1, 1999 Accepting new patients

Locations

707 Whitlock Ave SW
Ste A36
Marietta, GA 30064
Phone (770) 427-3033

990 Whitlock Ave NW
Ste D
Marietta, GA 30064
Phone (770) 427-3033

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361318400000",
    "number": "1811093784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 WHITLOCK AVE SW STE A36",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300644654",
            "telephone_number": "770-427-3033",
            "fax_number": "770-427-3035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 WHITLOCK AVE SW STE A36",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300644654",
            "telephone_number": "770-427-3033",
            "fax_number": "770-427-3035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "LAURIE",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2013-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "GA",
            "license": "1814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000817847E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; 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.