Individual provider Active NPI

Elisheva Fakheri

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1992391007
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN250323 Issued in GA
Practice address
865 N Highland Ave NE
Atlanta, GA 30306-4565
Phone
(404) 733-6089
NPI assigned
Dec 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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 RN250323 GA Primary

Addresses

Primary practice location

865 N Highland Ave NE
Atlanta, GA 30306-4565

Mailing address

865 N Highland Ave NE
Atlanta, GA 30306-4565
Phone (404) 733-6089

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
I20210517002357 GA Practitioner - Nurse Practitioner 9133538473 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

Practice addresses (Care Compare)

Atlanta, GA 30329
Phone (404) 877-8335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Toco Premier Care LLC CurrentSince Feb 1, 2023 Accepting new patients
Minuteclinic LLC Family CurrentSince Feb 16, 2021 Accepting new patients

Locations

3280 Peachtree Rd NE
Fl 7
Atlanta, GA 30305
Phone (678) 712-4236

865 N Highland Ave NE
Atlanta, GA 30306
Phone (404) 733-6089

11710 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 754-0141

7207 Rockbridge Rd
Stone Mtn, GA 30087
Phone (770) 469-2002

169 Laymon Rd
Swan Lake, NY 12783

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": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1992391007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 N HIGHLAND AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303064565",
            "telephone_number": "404-733-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 N HIGHLAND AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303064565",
            "telephone_number": "404-733-6089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKHERI",
        "first_name": "ELISHEVA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-14",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN250323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.