Stephanie J Elder, MD

Primary specialty

Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X

License

ME86077 Issued in FL

Practice address

5220 Belfort Rd
Ste 130
Jacksonville, FL 32256-6017

Phone

(727) 867-5480

Fax

(888) 507-9833

NPI assigned

Aug 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

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

Interoperability endpoints

• Direct secure messaging: selder1@direct-address.org

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.

• Advanced Wound Systems LLC

  • Durable Medical Equipment & Medical Supplies
  • St Petersburg, FL
  • NPI 1508054271
  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371772800000",
    "number": "1346356029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 BELFORT RD",
            "address_2": "STE 130",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566017",
            "telephone_number": "727-867-5480",
            "fax_number": "888-507-9833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 BELFORT RD",
            "address_2": "STE 130",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566017",
            "telephone_number": "727-867-5480",
            "fax_number": "888-507-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDER",
        "first_name": "STEPHANIE",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2013-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "FL",
            "license": "ME0086077",
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "FL",
            "license": "ME86077",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "FL",
            "license": "ME86077",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "92628",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00086589",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7788558",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267690700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rawdah Elbahrawi, MD
• Micheline Baz Elbahri, DDS
• Moustafa Elbehairy, DDS
• Joshua S Elder, M.D.
• Michelle Boling Elder, ATC
• Amy Jo Eldred
• Courtney Eldridge
• Marion C Eldridge Jr., DMD
• Jason S Eldrige, M.D.
• Jacob Raphael Eleazer, PHD

• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2013; 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.