Elizabeth Ann Mountcastle, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

00009695 Issued in AL

Practice address

286 Mitylene Park Dr
Montgomery, AL 36117-3548

Phone

(334) 396-1555

Fax

(334) 396-9833

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• James Stephen Maddox

  • Dermatology Physician
  • Montgomery, AL
  • NPI 1306902127
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1114037215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241627",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361241627",
            "telephone_number": "334-396-1555",
            "fax_number": "334-396-9833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 MITYLENE PARK DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173548",
            "telephone_number": "334-396-1555",
            "fax_number": "334-396-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUNTCASTLE",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AL",
            "license": "00009695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX#",
            "identifier": "631066099",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "510-82148",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "511-30221",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED TAX #",
            "identifier": "45-3970660",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "CM4358",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528501290",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Ellis Mount, PT, DSC
• Mary Jamie Mount, D.M.D.
• Michael T Mount, PA-C
• Mountain Smiles - Montgomery Mulberry PLLC
• Mountain Smiles - Montgomery Woods Crossing PLLC
• Lynette Moxey, FNP-C
• Sarah Anne Moyer
• Mt Internal Medicine Consulting LLC
• Mtgy. Assoc. for Retarded Citizens, Inc.
• Raghu Mukkamala, MD

• Dermatology Physician in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Dermatology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.