Individual provider Active NPI

Elizabeth Ann Bizzell, LMFT

  • Marriage & Family Therapist
  • Warner Robins, GA
National Provider Identifier
1912251083
Registry record updated Oct 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT1079 Issued in GA
Practice address
524 S Houston Lake Rd
Suite G
Warner Robins, GA 31088-9027
Phone
(478) 333-2498
Fax
(478) 333-6631
NPI assigned
Oct 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT1079 GA Primary

Addresses

Primary practice location

524 S Houston Lake Rd
Suite G
Warner Robins, GA 31088-9027

Mailing address

524 S Houston Lake Rd
Suite G
Warner Robins, GA 31088-9027
Phone (478) 333-2498

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240529000808 GA Practitioner - Marriage and Family Therapist 3274975883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Yorktown Dr
Fayetteville, GA 30214-1578

250 Martin Luther King Jr Blvd
Macon, GA 31201-3490
Phone (478) 301-4111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFT1079GAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC CurrentSince May 5, 2024 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince May 5, 2024 Accepting new patients

Locations

3715 Northside Pkwy NW
Bldg 100
Atlanta, GA 30327
Phone (404) 262-7414

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351468800000",
    "number": "1912251083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 S HOUSTON LAKE RD",
            "address_2": "SUITE G",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310889027",
            "telephone_number": "478-333-2498",
            "fax_number": "478-333-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 S HOUSTON LAKE RD",
            "address_2": "SUITE G",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310889027",
            "telephone_number": "478-333-2498",
            "fax_number": "478-333-6631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIZZELL",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-29",
        "last_updated": "2012-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT1079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.