NPIMap

Organization Active NPI

Mark J Elder DO PA

  • Family Medicine Physician
  • Milton, FL
National Provider Identifier
1154559409
Registry record updated Jun 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MARK J ELDER DO PA
Practice address
5992 Berryhill Rd
Milton, FL 32570-1013
Phone
(850) 981-0320
NPI assigned
Jun 25, 2009
Last updated
Jun 25, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2009

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

Authorized official

Name
Dr. Mark J Elder, DO PANPI 1477559409
Title
Owner
Phone
(850) 623-4070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

5992 Berryhill Rd
Milton, FL 32570-1013

Mailing address

5992 Berryhill Rd
Milton, FL 32570-1013
Phone (850) 981-0320

National Provider Directory

National Provider Directory

Locations

5992 Berryhill Rd
Milton, FL 32570
Phone (850) 623-9787

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245888000000",
    "number": "1154559409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5992 BERRYHILL RD",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325701013",
            "telephone_number": "850-981-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5992 BERRYHILL RD",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325701013",
            "telephone_number": "850-981-0320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK J ELDER DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-25",
        "last_updated": "2009-06-25",
        "status": "A",
        "authorized_official_last_name": "ELDER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-623-4070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO PA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; 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.