NPIMap

Organization Active NPI

Douglas R Elliott MD PC

  • Surgery Physician
  • Mt Pleasant, IA
National Provider Identifier
1376730531
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
23933 Issued in IA
Legal business name
DOUGLAS R ELLIOTT MD PC
Practice address
407 S White St
Suite 103
Mt Pleasant, IA 52641-2262
Phone
(319) 385-6166
Fax
(319) 385-6597
NPI assigned
Oct 1, 2007
Last updated
Oct 1, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Authorized official

Name
Douglas R Elliott, MD, PCNPI 1144361486
Title
President
Phone
(319) 385-6166

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 23933 IA Primary

Addresses

Primary practice location

407 S White St
Suite 103
Mt Pleasant, IA 52641-2262

Mailing address

407 S White St
Suite 103
Mt Pleasant, IA 52641-2262
Phone (319) 385-6166

Other identifiers 1

IdentifierTypeStateIssuer
0284927MedicaidIA

National Provider Directory

National Provider Directory

Locations

407 S White St
Ste 103
Mt Pleasant, IA 52641
Phone (319) 385-6166

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191196800000",
    "number": "1376730531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 S WHITE ST",
            "address_2": "SUITE 103",
            "city": "MT PLEASANT",
            "state": "IA",
            "postal_code": "526412262",
            "telephone_number": "319-385-6166",
            "fax_number": "319-385-6597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S WHITE ST",
            "address_2": "SUITE 103",
            "city": "MT PLEASANT",
            "state": "IA",
            "postal_code": "526412262",
            "telephone_number": "319-385-6166",
            "fax_number": "319-385-6597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS R ELLIOTT MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2007-10-01",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-385-6166",
        "authorized_official_credential": "MD, PC"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "23933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0284927",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.