Active NPI
Glenn Sik-Hee Poon, MD
- Family Medicine Physician
- Elberton, GA
National Provider Identifier
1508845629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 17268
- Practice address
- 109 College Ave
Elberton, GA 30635-1705 - Phone
- (706) 283-3315
- Fax
- (706) 283-2159
- NPI assigned
- Jan 17, 2006
- Last updated
- Jan 5, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 17268 | GA | Primary |
Addresses
Primary practice location
109 College Ave
Elberton, GA 30635-1705
Mailing address
109 College Ave
Elberton, GA 30635-1705
Phone (706) 283-3315
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00135429A4FP | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Medical College of Georgia School of Medicine, 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
109 College Ave
Elberton, GA 30635-1705
Phone (706) 283-3315
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17268 | GA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elbert Memorial Hospital | Past | Accepting new patients |
Interoperability endpoints
- glenn.poon@gadirect.net
- glennpoon@tmce.allscriptsdirect.net
Ownership & related parties
All facility ownership & control disclosures 3
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Elbert Memorial Hospital | Hospital | Corporate Director | Jan 1, 2017 |
| Elbert Memorial Hospital | Hospital | Corporate Director | Jan 1, 2017 |
| The Medical Center of Elberton LLP | Rural health clinic | 5% Or Greater Direct Ownership Interest (16.66%) General Partnership Interest (16.66%) |
Aug 1, 1995 Feb 22, 2005 |
Owned or controlled facilities with NPI records 2
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Rural Health Clinic/Center
- Elberton, GA
- NPI 1891863569
5% Or Greater Direct Ownership Interest, General Partnership Interest
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Rural Health Clinic/Center
- Elberton, GA
- NPI 1891863569
-
- Critical Access Hospital
- Elberton, GA
- NPI 1669488250
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Tuglaoo Home Health Agency, an Amedisys Company
- Home Health Agency
- Lavonia, GA
- NPI 1235187980
-
dba Enhabit Home Health
- Home Health Agency
- Hartwell, GA
- NPI 1740268176
-
- Critical Access Hospital
- Elberton, GA
- NPI 1669488250
-
- General Acute Care Hospital
- Athens, GA
- NPI 1437186111
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262649600000",
"number": "1508845629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 COLLEGE AVE",
"city": "ELBERTON",
"state": "GA",
"postal_code": "306351705",
"telephone_number": "706-283-3315",
"fax_number": "706-283-2159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 COLLEGE AVE",
"city": "ELBERTON",
"state": "GA",
"postal_code": "306351705",
"telephone_number": "706-283-3315",
"fax_number": "706-283-2159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POON",
"first_name": "GLENN",
"middle_name": "SIK-HEE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-17",
"last_updated": "2010-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "17268",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00135429A4FP",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elberton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.