ELISSA GLORIA FONTENOT NP
NPI 1386229839
Nurse Practitioner in Lithonia, GA

Q: What is Elissa Fontenot's NPI number?

The NPI number for Elissa Fontenot is 1386229839. It was assigned to this individual provider in the NPPES registry on March 16, 2021.

Q: What is Elissa Fontenot's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Elissa Fontenot was last updated on March 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 16, 2021PECOS Enrolled

2801 DEKALB MEDICAL PKWY, LITHONIA, GA 30058(404) 501-8000 Get Directions Write a Review

NPPES record last updated: March 16, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Elissa Gloria Fontenot Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELISSA GLORIA FONTENOT NP (NPI 1386229839) is an individual nurse practitioner in Lithonia, Georgia, licensed in Georgia (NCO-000003) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1386229839

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameELISSA GLORIA FONTENOTCredential: NP

Location Address2801 DEKALB MEDICAL PKWYLithonia, GA 30058-4996

Mailing Address105 Princeton CtCovington, GA 30016-2953 · (678) 793-3123

Phone(404) 501-8000

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateMarch 16, 2021

NPPES CertifiedFebruary 16, 2021

✔ NPI 1386229839 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in GA · NCO-000003

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedRegistered Nurse · General PracticeTaxonomy 163WG0000X · License RN241909 (GA)

2801 DEKALB MEDICAL PKWY, Lithonia, GA 30058

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elissa Gloria Fontenot Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9032603543

PECOS Enrollment IDI20251211002784

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30058 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LOUIS LEE M.D.

Internal Medicine