Individual provider Active NPI

Lynette M Elkins, CRNP

  • Family Nurse Practitioner
  • Dothan, AL
National Provider Identifier
1366987208
Registry record updated Jan 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-075631 Issued in AL
Practice address
2431 W Main St
Suite 1102
Dothan, AL 36301-1217
Phone
(334) 699-5780
Fax
(334) 699-5786
NPI assigned
Jan 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-075631 AL Primary

Addresses

Primary practice location

2431 W Main St
Suite 1102
Dothan, AL 36301-1217

Mailing address

2431 W Main St
Suite 1102
Dothan, AL 36301-1217
Phone (334) 699-5780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20170509001260 AL Practitioner - Nurse Practitioner 5092092684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gut PCGroup PAC ID 3375589799, 53 clinicians

Practice addresses (Care Compare)

480 Honeysuckle Rd
Dothan, AL 36305-1156
Phone (334) 836-1212

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gut PC CurrentSince Jul 12, 2017 Accepting new patients
Gut PC CurrentSince Jul 12, 2017 Accepting new patients

Locations

265 Medical Park Blvd
Dothan, AL 36301
Phone (334) 305-0112

480 Honeysuckle Rd
Dothan, AL 36305
Phone (334) 792-6933

614 N Main St
Ste A
Enterprise, AL 36330
Phone (334) 489-4244

2126 W Roy Parker Rd
Ste 202
Ozark, AL 36360
Phone (334) 443-0203

Organizations & group practices 2

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 2

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": "1483315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483315200000",
    "number": "1366987208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2431 W MAIN ST",
            "address_2": "SUITE 1102",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011217",
            "telephone_number": "334-699-5780",
            "fax_number": "334-699-5786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 W MAIN ST",
            "address_2": "SUITE 1102",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011217",
            "telephone_number": "334-699-5780",
            "fax_number": "334-699-5786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELKINS",
        "first_name": "LYNETTE",
        "middle_name": "M",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-02",
        "last_updated": "2017-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-075631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.