Margaret Ellen Eastham, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME69204 Issued in FL

Practice address

1030 Chalet Suzanne Rd
Lake Wales, FL 33859-7760

Phone

(863) 679-1818

Fax

(863) 679-1097

NPI assigned

Sep 19, 2006

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487808000000",
    "number": "1386741825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10744",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337578744",
            "telephone_number": "727-532-0002",
            "fax_number": "727-266-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 CHALET SUZANNE RD",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338597760",
            "telephone_number": "863-679-1818",
            "fax_number": "863-679-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTHAM",
        "first_name": "MARGARET",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-19",
        "last_updated": "2017-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME69204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252038900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Roberts Duncan, DVM
• Samantha Nicole Durkin, OTR/L
• Dva Healthcare Renal Care, Inc. (Lake Wales Dialysis Center)
• Chelsey Dziekiewicz, RPH
• Eagle Ridge Medical Center Co. (Blue Ridge Medical Center)
• Lee Wichner Edelstein, MD
• Hannah P Edmondson
• Mona Elsarraj
• Emanuel Support Services, Inc
• Emy Home Care Inc.

• Family Medicine Physician in Lake Wales, FL
• Providers in Lake Wales, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.