Larry Nelson Elam, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

053491 Issued in GA

Practice address

10055 Ford Ave
Ste 4a
Richmond Hill, GA 31324-3972

Phone

(912) 756-3075

Fax

(912) 756-5291

NPI assigned

Jul 14, 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 5

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Pediatric Medicine

Education

University of Kentucky College of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group of Georgia LLCGroup PAC ID 4284951542, 454 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
• Direct secure messaging: larry.elam.1@8042.direct.athenahealth.com
• Direct secure messaging: larrynelsonelam@scmgllc.allscriptsdirect.net

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.

• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Fayetteville, GA
  • NPI 1013313857
  Medicare reassignment Care Compare group NPD
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1356907273
  NPD

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1306844170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10055 FORD AVE",
            "address_2": "STE 4A",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313243972",
            "telephone_number": "912-756-3075",
            "fax_number": "912-756-5291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10055 FORD AVE",
            "address_2": "STE 4A",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313243972",
            "telephone_number": "912-756-3075",
            "fax_number": "912-756-5291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELAM",
        "first_name": "LARRY",
        "middle_name": "NELSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "053491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "888120761A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G53491",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS RICHMOND HILL",
            "identifier": "206521",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS SAVANNAH",
            "identifier": "260521",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "888120761B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miranda Bethany Earley
• Eastern Wellness Center, PC
• Feige Edwards, RBT
• Effingham Rehab Services, LLC
• Lawrence Ndubuisi Ejindu, B.PHARM
• Delon Elem, PHARMD, RPH
• Flavie Eljam
• Lakendra Elliott
• Kenpril Kenise Ellis
• Karen Lee Emenheiser, LCSW

• Pediatrics Physician in Richmond Hill, GA
• Providers in Richmond Hill, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.