Clyde H Elder Jr., APRN,BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

RN0000048298 Issued in TN

Practice address

3461 Austin Peay Hwy
Memphis, TN 38128-3801

Phone

(901) 261-4500

Fax

(901) 261-4511

NPI assigned

Aug 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649288424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6785 RICKS RD",
            "city": "ARLINGTON",
            "state": "TN",
            "postal_code": "380026907",
            "telephone_number": "901-873-3923",
            "fax_number": "901-261-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3461 AUSTIN PEAY HWY",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381283801",
            "telephone_number": "901-261-4500",
            "fax_number": "901-261-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDER",
        "first_name": "CLYDE",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "APRN,BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TN",
            "license": "RN0000048298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marshall B. Elam, M.D.
• Cheran Elangovan, M.D.,
• Lama Ma Elbahlawan, MD
• Elder Care Social Services
• Elder Care, Inc.
• Mohammad Eldomery, M.D.
• Elect Home Care, LLC
• Darryl Elefan, M.D.
• Elements of Life
• Shelby Nichole Elenburg, M.D.

• Primary Care Nurse Practitioner in Memphis, TN
• Providers in Memphis, TN by specialty
• Primary Care Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.