Richard Lowen Elliott, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

M4909 Issued in ID

Practice address

500 South 11TH Ave
Suite 206
Pocatello, ID 83201

Phone

(208) 232-3480

Fax

(208) 233-6585

NPI assigned

Oct 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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.

• Sharon Richens MD Eye Physician & Surgeon PC

  • Ophthalmology Physician
  • Mesquite, NV
  • NPI 1023507928
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184708703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SOUTH 11TH AVE",
            "address_2": "SUITE 206",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-232-3480",
            "fax_number": "208-233-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SOUTH 11TH AVE",
            "address_2": "SUITE 206",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-232-3480",
            "fax_number": "208-233-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "RICHARD",
        "middle_name": "LOWEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ID",
            "license": "M4909",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "GFE9724",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Lee Eldredge
• Elegant Residential Living Inc
• Elevate Fitx, LLC
• Elevate PT LLC
• Anna Elliott, MA, LPC
• Ryan M. Elliott, BS
• Marina J. Ellis, LCPC
• Lauren Elizabeth Ellsworth
• Brooke Elzey, PA-C
• Emeritus Corporation

• Ophthalmology Physician in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Ophthalmology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.