Active NPI
Wayne Gordon Elliott, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- North Palm Beach, FL
National Provider Identifier
1750505087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- R-1940
- Practice address
- 105 Paradise Harbour Blvd
Apt. 202
North Palm Beach, FL 33408-5045 - Phone
- (870) 918-9313
- NPI assigned
- Apr 11, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | R-1940 | AR | Primary |
Addresses
Primary practice location
105 Paradise Harbour Blvd
Apt. 202
North Palm Beach, FL 33408-5045
Mailing address
105 Paradise Harbour Blvd
Apt. 202
North Palm Beach, FL 33408-5045
Phone (870) 918-9313
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-1940 | AR | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750505087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 PARADISE HARBOUR BLVD",
"address_2": "APT. 202",
"city": "NORTH PALM BEACH",
"state": "FL",
"postal_code": "334085045",
"telephone_number": "870-918-9313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 PARADISE HARBOUR BLVD",
"address_2": "APT. 202",
"city": "NORTH PALM BEACH",
"state": "FL",
"postal_code": "334085045",
"telephone_number": "870-918-9313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "WAYNE",
"middle_name": "GORDON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "AR",
"license": "R-1940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Palm Beach, FL
Sources for this page
- 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.