Individual provider Active NPI

Elisha Elyse Webster, M.D.

  • Family Medicine Physician
  • Blue Earth, MN
National Provider Identifier
1336592633
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
74343 Issued in MN
Practice address
515 S Moore St
Blue Earth, MN 56013-2158
Phone
(507) 526-3273
Fax
(507) 526-2467
NPI assigned
Jul 21, 2016
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RL14238 ND
Family Medicine Physician 207Q00000X 74343 MN Primary

Addresses

Primary practice location

515 S Moore St
Blue Earth, MN 56013-2158

Mailing address

515 S Moore St
Blue Earth, MN 56013-2158
Phone (507) 526-3273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210831001031 GA Practitioner - Family Practice 0941606974 Reassigns benefits to 1 organization
I20230725003784 MN Practitioner - Family Practice 0941606974 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Dakota School of Medicine, 2016
Medicare assignment
May accept Medicare assignment
Group practices
United Hospital District IncGroup PAC ID 6204158884, 50 clinicians

Practice addresses (Care Compare)

515 S Moore St
Blue Earth, MN 56013-2158
Phone (507) 526-7388

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
RL14238NDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Specialty Associates, LLC Family Medicine CurrentSince Sep 6, 2021 Accepting new patients
United Hospital District Inc. Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
United Hospital District Inc. PastSince Oct 31, 2021 Accepting new patients

Locations

1364 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 712-7100

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

515 S Moore St
Blue Earth, MN 56013
Phone (507) 526-3273

1950 Center Creek Dr
Fairmont, MN 56031
Phone (507) 238-1287

Interoperability endpoints

  • Direct secure messaging: ewebster20172@direct.emory.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1336592633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 S MOORE ST",
            "city": "BLUE EARTH",
            "state": "MN",
            "postal_code": "560132158",
            "telephone_number": "507-526-3273",
            "fax_number": "507-526-2467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S MOORE ST",
            "city": "BLUE EARTH",
            "state": "MN",
            "postal_code": "560132158",
            "telephone_number": "507-526-3273",
            "fax_number": "507-526-2467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "ELISHA",
        "middle_name": "ELYSE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-21",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "RL14238",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "74343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Earth, MN

Sources for this page

Verify at the official NPI Registry.