Elizabeth Justine Nourse, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

57.253352 Issued in OH

Practice address

725 University Blvd
Fairborn, OH 45324

Phone

(937) 245-7200

NPI assigned

May 19, 2021

Last updated

Apr 21, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: elizabeth.nourse.1@19221.direct.athenahealth.com
• Direct secure messaging: elizabeth.nourse.1@415.direct.athenahealth.com

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1952975344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 MOHAWK ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432062111",
            "telephone_number": "260-450-8784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 UNIVERSITY BLVD",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "45324",
            "telephone_number": "937-245-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOURSE",
        "first_name": "ELIZABETH",
        "middle_name": "JUSTINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "57.253352",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "57.253352",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Non-Agency Provider
• Christian Nordenstrom
• Joshua Nordstrom, LSW
• Kamerin Norris, CDCA
• Lisa Norris
• Trent H Nourse, PA-C, MPAS
• Michael Anene Nwankwo, RPH
• Stephane Fuashi Nyoh
• O'Neill Enterprises LLC (Dayton Discount Furniture)
• Francis Jay O'Neill

• Dermatology Physician in Fairborn, OH
• Providers in Fairborn, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.