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EMMIE NORVILLE PARK NNP
NPI 1912419151
Nurse Practitioner - Neonatal in Augusta, GA

Active since October 27, 2017PECOS Enrolled
1120 15TH ST # 6033, AUGUSTA, GA 30912(706) 721-2331(706) 721-7531 Get Directions Write a Review

NPPES record last updated: November 29, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 29, 2017, Oct 27, 2017 (2 updates tracked since 2017).

About Emmie Norville Park Nnp NPPES

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

EMMIE NORVILLE PARK NNP (NPI 1912419151) is an individual neonatal provider in Augusta, Georgia, licensed in Georgia (RN227108) and active in the NPI registry since October 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912419151
Entity TypeIndividualFemale
Primary Taxonomy363LN0000X
Provider Legal NameEMMIE NORVILLE PARKCredential: NNP
Location Address1120 15TH ST # 6033Augusta, GA 30912-0004
Mailing Address1499 Walton Way Ste 1400Augusta, GA 30901-2603 · (706) 446-5941
Phone(706) 721-2331
Fax(706) 721-7531
Sole ProprietorNo
Enumeration DateOctober 27, 2017
Last NPPES UpdateNovember 29, 20172 updates tracked since enumeration
✔ NPI 1912419151 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · NeonatalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LN0000X
License✔ Licensed in GA · RN227108
1120 15TH ST # 6033, Augusta, GA 30912
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Emmie Norville Park Nnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Emmie Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Wellstar Medical Group, LLC
140 mi
Family Medicine
11685 ALPHARETTA HWY, SUITE 300
Roswell, GA 30076
  • Reassigned Medicare billing, Georgia enrollment
  • 3,885 clinicians in this Medicare group
NPI 1922405729 (678) 325-6611

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30912 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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 2

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

THUY THU-THI NGUYEN NNP
Nurse Practitioner (Neonatal, Critical Care)
1120 15TH ST # 6033
AUGUSTA, GA 30912
Richmond County (706) 721-2331
MRS. CHRISTY MARIE GARDNER NNP
Nurse Practitioner (Neonatal, Critical Care)
1120 15TH ST # 6033
AUGUSTA, GA 30912
Richmond County (706) 721-2331

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Emmie Park's NPI number?

The NPI number for Emmie Park is 1912419151. It was assigned to this individual provider in the NPPES registry on October 27, 2017.

Where is Emmie Park located?

Emmie Park practices at 1120 15th St # 6033, Augusta, GA 30912. The listed phone number is (706) 721-2331.

What is Emmie Park's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Neonatal, with taxonomy code 363LN0000X.

Is Emmie Park enrolled in Medicare?

Yes. Emmie Park is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Emmie Park's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Emmie Park reassigns Medicare benefits to Wellstar Medical Group, LLC (Roswell, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Emmie Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Emmie Park accept?

Health plans from Alliant Health Plans, Inc. list Emmie Park as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Emmie Park was last updated on November 29, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.