Individual provider Active NPI

Elizabeth Nadra Smith, FNP-C

  • Family Nurse Practitioner
  • Stockbridge, GA
National Provider Identifier
1942948369
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN085855 Issued in GA
Practice address
1240 Eagles Landing Pkwy Ste 110
Stockbridge, GA 30281-5173
Phone
(770) 389-3855
NPI assigned
May 25, 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN085855 GA Primary

Addresses

Primary practice location

1240 Eagles Landing Pkwy Ste 110
Stockbridge, GA 30281-5173

Mailing address

3333 Riverwood Pkwy SE Ste 250
Atlanta, GA 30339-3304
Phone (770) 914-0116

Other identifiers 2

IdentifierTypeStateIssuer
RN085855OtherGASTATE BOARD OF NURSING
F05210353OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS NATIONAL CERTIFICATION BOARD

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
I20221212001854 GA Practitioner - Nurse Practitioner 6709255862 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aylo Health, LLCGroup PAC ID 8022901925, 112 clinicians

Practice addresses (Care Compare)

1240 Eagles Landing Pkwy
Suite 110
Stockbridge, GA 30281-5173
Phone (770) 914-0116

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN085855GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aylo Health, LLC Current Accepting new patients
Peachtree Immediate Care FP, LLC CurrentSince Dec 1, 2022 Accepting new patients
Aylo Health, LLC CurrentSince Oct 1, 2024 Accepting new patients
Aylo Health, LLC CurrentSince Oct 1, 2024 Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients

Locations

3333 Riverwood Pkwy SE
Ste 250
Atlanta, GA 30339
Phone (770) 914-0016

1101 Nortec Dr SE
Conyers, GA 30013
Phone (678) 374-7514

590 Lanier Ave W
Fayetteville, GA 30214

1275 Highway 54 W
Ste 201
Fayetteville, GA 30214
Phone (770) 461-3776

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

2130 W Spring St
Ste 300
Monroe, GA 30655
Phone (678) 905-9121

1240 Eagles Landing Pkwy
Ste 110
Stockbridge, GA 30281
Phone (770) 389-3855

145 Eagles Walk
Ste A
Stockbridge, GA 30281
Phone (770) 389-3855

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1942948369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 RIVERWOOD PKWY SE STE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393304",
            "telephone_number": "770-914-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 EAGLES LANDING PKWY STE 110",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815173",
            "telephone_number": "770-389-3855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ELIZABETH",
        "middle_name": "NADRA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-25",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN085855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF NURSING",
            "identifier": "RN085855",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS NATIONAL CERTIFICATION BOARD",
            "identifier": "F05210353",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.