Clyde Dale Elliott, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

6974 Issued in AL

Practice address

1022 1St St N
Suite 500
Alabaster, AL 35007-8706

Phone

(205) 663-5775

Fax

(205) 664-2112

NPI assigned

Dec 27, 2005

Sex

Male

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Cardiovascular Associates of North Alabama, P.C.

  • Cardiovascular Disease Physician
  • Birmingham, AL
  • NPI 1295784148

  Cardiovascular Disease

  NPD (past)
• Heart South Cardiovascular Group, P.C.

  • Cardiovascular Disease Physician
  • Alabaster, AL
  • NPI 1588641005

  Cardiovascular Disease

  NPD (past)

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1124005673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 1ST ST N",
            "address_2": "SUITE 500",
            "city": "ALABASTER",
            "state": "AL",
            "postal_code": "350078706",
            "telephone_number": "205-663-5775",
            "fax_number": "205-664-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 1ST ST N",
            "address_2": "SUITE 500",
            "city": "ALABASTER",
            "state": "AL",
            "postal_code": "350078706",
            "telephone_number": "205-663-5775",
            "fax_number": "205-664-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "CLYDE",
        "middle_name": "DALE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AL",
            "license": "6974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051552706",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas E Dudney, DMD
• Heinz Alexander Dueffer, M.D.
• Jacqueline Capps Duke, C.R.N.P.
• E Simmons Inc
• Ahmad El Estwani, DMD
• Alexandria Kendall Ellis, RN
• Ember & Oak Counseling LLC
• Harold Keith Emmons, DMD
• Empowered Wellnesss Physical Therapy, LLC
• Encore Rehabilitation, Inc

• All providers in Alabaster, AL
• Cardiovascular Disease Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; 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.