Elizabeth Illing, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN079340 Issued in GA

Practice address

200 S Enota Dr NE Ste 100
Gainesville, GA 30501

Phone

(770) 534-2020

Fax

(770) 534-8025

NPI assigned

Nov 22, 2013

Last updated

Dec 8, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Elizabeth Ann Holiday Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Davids Heart and Vascular PLLCGroup PAC ID 7012821879, 197 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St David's Medical Center Hospital, Austin, TX, CCN 450431
• Christus Santa Rosa Hospital-San Marcos Hospital, San Marcos, TX, CCN 450272

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• St Davids Heart & Vascular, PLLC

  • Cardiovascular Disease Physician
  • Austin, TX
  • NPI 1700887700
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christus Santa Rosa Health Care Corporation

  dba Christus Santa Rosa Hospital - New Braunfels

  • General Acute Care Hospital
  • New Braunfels, TX
  • NPI 1114725033
  Care Compare affiliation
• Christus Santa Rosa Health Care Corporation

  dba Christus Santa Rosa Hospital - San Marcos

  • General Acute Care Hospital
  • San Marcos, TX
  • NPI 1447883301
  Care Compare affiliation
• St. Davids Healthcare Partnership, L.P., LLP

  dba Heart Hospital of Austin

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1720033947
  Care Compare affiliation

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1851721161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S ENOTA DR NE STE 100",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "telephone_number": "770-534-2020",
            "fax_number": "770-534-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILLING",
        "first_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-22",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN079340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eilling94305@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "200 S Enota Dr NE Ste 100",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "HOLIDAY",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• I Heart Therapy, LLC
• Maria Guadalupe Ibarra, MS
• Cindy Mambwe Idowu, MD
• Terralene Igbokwe, RPH
• Samuel Ighodaro
• Jawad Ilyas, M.D
• Independent Physical Therapy of Ga LLC (Benchmark PT)
• Independent Physical Therapy of Ga, LLC
• Independent Physical Therapy of Ga, LLC
• Independent Physical Therapy of Georgia, LLC (Benchmark PT)

• Family Nurse Practitioner in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.