John L Elfervig, M.D.

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

9929 Issued in TN

Practice address

825 Ridge Lake Blvd
Memphis, TN 38120-9411

Phone

(901) 685-2200

Fax

(901) 820-2342

NPI assigned

Jun 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in TN

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515974400000",
    "number": "1619910544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 RIDGE LAKE BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209411",
            "telephone_number": "901-685-2200",
            "fax_number": "901-820-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 RIDGE LAKE BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209411",
            "telephone_number": "901-685-2200",
            "fax_number": "901-820-2342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELFERVIG",
        "first_name": "JOHN",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2018-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "MD009929",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AR",
            "license": "R4424",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MS",
            "license": "14866",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MS",
            "license": "14866",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "AR",
            "license": "R4424",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "TN",
            "license": "9929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RR MEDICARE",
            "identifier": "P00658339",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RR MEDICARE",
            "identifier": "180024050",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00115592",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107447001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3190249",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202004503",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darryl Elefan, M.D.
• Elements of Life
• Shelby Nichole Elenburg, M.D.
• Elevate Memphis Inc
• Elevated Home Care Solutions, LLC
• Lucie S. Elfervig, D.N.S., A.P.R.N.
• Kabura Elice
• Lucas Elijovich, MD
• Audrey A. Elion, M.S., PH. D.
• Lolita Rochelle Elion

• Retina Specialist (Ophthalmology) Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Retina Specialist (Ophthalmology) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.