Dudley G Elmore III, RN,FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

18199 Issued in CA

Practice address

200 W Arbor Drive
MC 8401
San Diego, CA 92103-8401

Phone

(619) 543-5870

Fax

(619) 543-7785

NPI assigned

May 29, 2008

Last updated

Oct 16, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Doug G Elmore Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

Practice roles

Locations

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.

• Regents of the University of California

  • Pain Medicine (Anesthesiology) Physician
  • San Diego, CA
  • NPI 1376646869
  NPD
• Regents of the University of California

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1508968751
  NPD
• Regents of the University of California

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1558463927
  NPD
• Regents of the University of California

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1578672184
  NPD
• Regents of the University of California

  • Surgery Physician
  • San Diego, CA
  • NPI 1740382993
  NPD
• UC San Diego Health Community Group

  • Community Health Clinic/Center
  • San Diego, CA
  • NPI 1659864247
  NPD

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1568620375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DRIVE",
            "address_2": "MC 8401",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921038401",
            "telephone_number": "619-543-5870",
            "fax_number": "619-543-7785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMORE",
        "first_name": "DUDLEY",
        "middle_name": "G",
        "name_suffix": "III",
        "credential": "RN,FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-29",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "18199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOUG",
            "last_name": "ELMORE",
            "middle_name": "G",
            "credential": "FNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kowser M. Elmi
• Payaam Elmi, RN
• Sagal Elmi, PSY.D.
• Elmira Khodapanah DDS Inc
• Alyssa Rena Elmore, PHARMD
• Kyle Patrick Elmore, DDS
• Elias Elmouttaqi
• Khaled Elnaggar
• Mohamed Bassyounyaboueleinin Elnaggar, MD
• Eloise R. Johnston & Associates (Laurie Silverman & Associates)

• Family Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; 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.