Individual provider Active NPI

Elizabeth Boxx Haggerty

  • Surgical Physician Assistant
  • Nashville, TN
National Provider Identifier
1902553266
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
4868 Issued in TN
Practice address
300 20TH Ave N Ste 301
Nashville, TN 37203-2173
Phone
(615) 284-1400
Fax
(615) 284-3089
NPI assigned
Mar 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 4868 TN Primary
Physician Assistant 363A00000X 4868 TN

Addresses

Primary practice location

300 20TH Ave N Ste 301
Nashville, TN 37203-2173

Mailing address

300 20TH Ave N Ste 301
Nashville, TN 37203-2173
Phone (615) 284-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20220616001750 TN Practitioner - Physician Assistant 5395124614 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Thomas Medical PartnersGroup PAC ID 1557269354, 588 clinicians

Practice addresses (Care Compare)

300 20TH Ave N
Nashville, TN 37203-2131
Phone (615) 284-1400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4868TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarksville Physician Services LLC Physician Assistant CurrentSince Jul 1, 2022 Accepting new patients
Saint Thomas Medical Partners CurrentSince Aug 1, 2024 Accepting new patients
Saint Thomas Medical Partners CurrentSince Aug 1, 2024 Accepting new patients

Locations

647 Dunlop Ln
Ste 210
Clarksville, TN 37040
Phone (931) 502-3810

651 Dunlop Ln
Clarksville, TN 37040
Phone (931) 502-1000

300 20th Ave N
Ste 301
Nashville, TN 37203
Phone (615) 284-2400

300 20th Ave N
Fl 9
Nashville, TN 37203

300 20th Ave N
Ste 403
Nashville, TN 37203
Phone (615) 284-4088

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7654/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/1879/brand/1/csg/1/fhir/r4
  • Direct secure messaging: elizabeth.haggerty.1@7654.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1902553266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 20TH AVE N STE 301",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032173",
            "telephone_number": "615-284-1400",
            "fax_number": "615-284-3089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 20TH AVE N STE 301",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032173",
            "telephone_number": "615-284-1400",
            "fax_number": "615-284-3089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGGERTY",
        "first_name": "ELIZABETH",
        "middle_name": "BOXX",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-07",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "4868",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4868",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.