NPIMap

Organization Active NPI

Trimed Advance Health, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Waycross, GA
National Provider Identifier
1689140600
Registry record updated Mar 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
TRIMED ADVANCE HEALTH, LLC
Practice address
2015 Alice St
Waycross, GA 31501-6209
Phone
(912) 490-3633
Fax
(912) 490-3700
NPI assigned
Oct 17, 2018
Last updated
Mar 8, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2019

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

Authorized official

Name
Frank Eldridge, MDNPI 1467814228
Title
Partner
Phone
(912) 548-6480

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X
Internal Medicine Physician 207R00000X
Geriatric Medicine (Internal Medicine) Physician 207RG0300X Primary

Addresses

Primary practice location

2015 Alice St
Waycross, GA 31501-6209

Mailing address

2015 Alice St
Waycross, GA 31501-6209
Phone (912) 548-6480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190107001071 GA Part B Supplier - Clinic/Group Practice 3577809904 Receives reassigned benefits from 7 practitioners
Practice locations: Waycross, GA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18622/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552003200000",
    "number": "1689140600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016209",
            "telephone_number": "912-548-6480",
            "fax_number": "912-283-4612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016209",
            "telephone_number": "912-490-3633",
            "fax_number": "912-490-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIMED ADVANCE HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-17",
        "last_updated": "2019-03-08",
        "status": "A",
        "authorized_official_last_name": "ELDRIDGE",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "912-548-6480",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.