Individual provider Active NPI

Elisha A Tribble, ARNP

  • Family Nurse Practitioner
  • Macon, GA
National Provider Identifier
1992933329
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
PENDING Issued in GA
Practice address
400 Charter Blvd
Macon, GA 31210-4831
Phone
(478) 757-6000
NPI assigned
Jun 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN171306 GA
Family Nurse Practitioner 363LF0000X PENDING GA Primary

Addresses

Primary practice location

400 Charter Blvd
Macon, GA 31210-4831

Mailing address

103 Troon Way
Macon, GA 31210-2910
Phone (478) 361-2195

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
I20091023000407 GA Practitioner - Nurse Practitioner 0446397442 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Medical College of Georgia School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

400 Charter Blvd
Macon, GA 31210-4831
Phone (478) 757-8200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PENDINGGAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians - Southeast PC CurrentSince Jul 31, 2019 Accepting new patients
Georgia Em-I Medical Services PC CurrentSince May 1, 2015 Accepting new patients
Georgia Em-I Medical Services. LLC Current Accepting new patients
Georgia Em-I Medical Services, LLC CurrentSince May 1, 2015 Accepting new patients
Vineville Internal Medicine LLC CurrentSince Nov 2, 2015 Accepting new patients
East Georgia Healthcare Center Inc Past Accepting new patients
East Georgia Healthcare Center, Inc. Past Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients

Locations

200 Allen Memorial Dr
Bremen, GA 30110
Phone (770) 537-5851

5126 Hospital Dr NE
Covington, GA 30014
Phone (770) 385-4340

200 Industrial Blvd
Dublin, GA 31021
Phone (478) 274-3865

350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367

3448 Vineville Ave
Macon, GA 31204
Phone (478) 405-0045

400 Charter Blvd
Macon, GA 31210
Phone (478) 757-6000

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

Organizations & group practices 8

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": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1992933329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 TROON WAY",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102910",
            "telephone_number": "478-361-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CHARTER BLVD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312104831",
            "telephone_number": "478-757-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIBBLE",
        "first_name": "ELISHA",
        "middle_name": "A",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-24",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN171306",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.