Individual provider Active NPI

Edward Olin Elrod, ARNP

  • Acute Care Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1265817233
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
9216397 Issued in FL
Practice address
409 Bayshore Blvd
Tampa, FL 33606-2707
Phone
(813) 844-5470
NPI assigned
Jul 20, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 9216397 FL Primary

Addresses

Primary practice location

409 Bayshore Blvd
Tampa, FL 33606-2707

Mailing address

409 Bayshore Blvd
Tampa, FL 33606-2707
Phone (813) 844-5470

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eelrod12975@direct.tgh.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151209001811 FL Practitioner - Nurse Practitioner 9032410493 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Florida College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Kidney Physicians LLCGroup PAC ID 4385925650, 167 clinicians

Practice addresses (Care Compare)

12662 Telecom Dr
Temple Terrace, FL 33637-0935
Phone (813) 910-0030

Hospital & facility affiliations

  • Tampa General Hospital Hospital, Tampa, FL, CCN 100128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9216397FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Medical Group Inc CurrentSince Apr 1, 2016 Accepting new patients
Tampa General Medical Group Inc CurrentSince Apr 1, 2016 Accepting new patients
Florida Kidney Physicians, LLC CurrentSince May 1, 2017 Accepting new patients
Tampa General Medical Group Inc Current Accepting new patients
Florida Kidney Physicians , LLC CurrentSince May 1, 2017 Accepting new patients

Locations

214 Morrison Rd
Ste 110
Brandon, FL 33511
Phone (800) 844-9302

409 Bayshore Blvd
Tampa, FL 33606
Phone (813) 253-2640

5802 N 30th St
Tampa, FL 33610
Phone (813) 236-5100

409 Bayshore Blvd
Fl 4
Tampa, FL 33606
Phone (813) 910-8708

12662 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 910-8708

2433 Country Place Blvd
Trinity, FL 34655
Phone (813) 844-8200

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1265817233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 BAYSHORE BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062707",
            "telephone_number": "813-844-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 BAYSHORE BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062707",
            "telephone_number": "813-844-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELROD",
        "first_name": "EDWARD",
        "middle_name": "OLIN",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-20",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "9216397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eelrod12975@direct.tgh.org",
            "affiliation": "N",
            "address_1": "409 Bayshore Blvd",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336062707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.