Organization Active NPI

Elmore Alexander D.O.,P.C.

  • Family Medicine Physician
  • Stone Mountain, GA
National Provider Identifier
1083029649
Registry record updated Jun 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
033908 Issued in GA
Legal business name
ELMORE ALEXANDER D.O.,P.C.
Practice address
374 Osprey PT
Stone Mountain, GA 30087-6163
Phone
(678) 371-2204
Fax
(678) 805-0077
NPI assigned
Jun 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2014

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

Authorized official

Name
Mrs. Diane Alexander
Title
Manager
Phone
(678) 371-2204

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 033908 GA Primary

Addresses

Primary practice location

374 Osprey PT
Stone Mountain, GA 30087-6163

Mailing address

374 Osprey PT
Stone Mountain, GA 30087-6163
Phone (678) 371-2204

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403481600000",
    "number": "1083029649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 OSPREY PT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300876163",
            "telephone_number": "678-371-2204",
            "fax_number": "678-805-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 OSPREY PT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300876163",
            "telephone_number": "678-371-2204",
            "fax_number": "678-805-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMORE ALEXANDER D.O.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-06-23",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "678-371-2204",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "033908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.