Individual provider Active NPI

Elizabeth Aguanta Bulatao, FNP

  • Adult Health Nurse Practitioner
  • Darien, GA
National Provider Identifier
1992888754
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN137184 Issued in GA
Practice address
5873 US Highway 17
Darien, GA 31305-4062
Phone
(912) 450-9750
Fax
(833) 468-5564
NPI assigned
Oct 23, 2006
Last updated
Aug 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN137184 GA Primary

Addresses

Primary practice location

5873 US Highway 17
Darien, GA 31305-4062

Mailing address

5873 US Highway 17
Darien, GA 31305-4062
Phone (912) 450-9750

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
I20070517000311 GA Practitioner - Nurse Practitioner 5395842876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cooperative Healthcare Services IncGroup PAC ID 9830093640, 235 clinicians

Practice addresses (Care Compare)

2415 Parkwood Dr
Brunswick, GA 31520-4722
Phone (912) 466-4079

3222 Shrine Rd a
Brunswick, GA 31520-4357
Phone (912) 264-6303

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.36 of 100Reported as group
Quality
46.72
Promoting interoperability
99
Improvement activities
40
Cost
75.31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN137184GAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cooperative Healthcare Services Inc CurrentSince Nov 11, 2013 Accepting new patients
Golden Isles Coastal Medicine, LLC CurrentSince Jun 25, 2026 Accepting new patients
Mary Lee Carter, MD-PC Past Accepting new patients

Locations

1111 Glynco Pkwy
Ste 400
Brunswick, GA 31525
Phone (912) 262-1801

2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079

2500 Starling St
Ste 401
Brunswick, GA 31520
Phone (912) 554-0544

3222 Shrine Rd
Ste A
Brunswick, GA 31520
Phone (912) 264-6303

3226 Hampton Ave
Ste C
Brunswick, GA 31520
Phone (912) 261-0044

5873 US Highway 17
Ste A
Darien, GA 31305

308 Bedell Ave
Woodbine, GA 31569
Phone (912) 576-5506

Interoperability endpoints

  • Direct secure messaging: ebulat2@secure.sghsmessaging.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1992888754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5873 US HIGHWAY 17",
            "city": "DARIEN",
            "state": "GA",
            "postal_code": "313054062",
            "telephone_number": "912-450-9750",
            "fax_number": "833-468-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5873 US HIGHWAY 17",
            "city": "DARIEN",
            "state": "GA",
            "postal_code": "313054062",
            "telephone_number": "912-450-9750",
            "fax_number": "833-468-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULATAO",
        "first_name": "ELIZABETH",
        "middle_name": "AGUANTA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN137184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Darien, GA

Sources for this page

Verify at the official NPI Registry.