NPIMap

Individual provider Active NPI

John William Elliott, D.O.

  • Nephrology Physician
  • Tupelo, MS
National Provider Identifier
1508245226
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
27409 Issued in MS
Practice address
1542 Medical Park Cir
Tupelo, MS 38801-6560
Phone
(662) 844-4711
NPI assigned
May 27, 2015
Last updated
Feb 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 27409 MS Primary

Addresses

Primary practice location

1542 Medical Park Cir
Tupelo, MS 38801-6560

Mailing address

1542 Medical Park Cir
Tupelo, MS 38801-6560
Phone (662) 844-4711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170817000088 AL Practitioner - Internal Medicine 7911279542 Reassigns benefits to 1 organization
I20200521002532 MS Practitioner - NephrologyPractitioner - Internal Medicine 7911279542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
William Carey University College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology and Hypertension Associates LTDGroup PAC ID 1254327554, 19 clinicians

Practice addresses (Care Compare)

1542 Medical Park Cir
Tupelo, MS 38801-6560
Phone (662) 844-4711

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Mountain Group Services, LLC Current Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Oak Mountain Group Services, LLC CurrentSince Jun 1, 2017 Accepting new patients
Nephrology & Hypertension Associates, LTD. Nephrology CurrentSince Jul 1, 2020 Accepting new patients
Baptist Health System, Inc. Past Accepting new patients

Locations

800 Montclair Rd
Birmingham, AL 35213
Phone (205) 592-1000

3070 Healthy Way
Vestavia, AL 35243
Phone (205) 977-7216

3690 Grandview Pkwy
Vestavia, AL 35243
Phone (205) 592-1000

3301 Tinin Dr
Corinth, MS 38834
Phone (662) 665-9111

1542 Medical Park Cir
Tupelo, MS 38801
Phone (662) 680-9610

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/JADIBA
  • Direct secure messaging: jelliott30297@direct.acumenmd.com
  • Direct secure messaging: johnelliott@nmhs.medalliesdirect.net

Organizations & group practices 5

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 5

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": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1508245226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1542 MEDICAL PARK CIR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016560",
            "telephone_number": "662-844-4711",
            "fax_number": "662-844-9619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 MEDICAL PARK CIR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016560",
            "telephone_number": "662-844-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-27",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MS",
            "license": "27409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.