Individual provider Active NPI

Jeffrey Sloan, MD

  • Emergency Medicine Physician
  • Atmore, AL
National Provider Identifier
1790724276
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
14752 Issued in AL
Practice address
401 Medical Park Dr
Atmore, AL 36502-3006
Phone
(904) 805-1300
Fax
(904) 805-1302
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 14752 AL Primary

Addresses

Primary practice location

401 Medical Park Dr
Atmore, AL 36502-3006

Mailing address

PO Box 863535
Orlando, FL 32886-3535
Phone (904) 805-1300

Other identifiers 1

IdentifierTypeStateIssuer
51521952OtherALBLUE CROSS

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20210310002480 AL Practitioner - Emergency Medicine 0345146569 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14752LAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ivy Creek of Tallapoosa LLC Current Accepting new patients
Ivy Creek of Elmore, LLC CurrentSince Mar 1, 2021 Accepting new patients
Ivy Creek of Tallapoosa CurrentSince Mar 1, 2021 Accepting new patients
Ivy Creek of Elmore, LLC Current Accepting new patients
Ivy Creek of Tallapoosa, LLC CurrentSince Mar 1, 2021 Accepting new patients
Ivy Creek of Elmore, LLC CurrentSince Mar 1, 2021 Accepting new patients
Baldwin Emergency Physicians, P.C.. Emergency Medicine Past Accepting new patients
Andalusia Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Stone County Hospital, Inc Past Accepting new patients
Clanton Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Southern Medical Group, Inc Emergency Medicine Past Accepting new patients

Locations

301 Mariarden Rd
Ste D
Dadeville, AL 36853
Phone (256) 825-7871

201 Mariarden Rd
Dadeville, AL 36853
Phone (256) 825-0677

500 Hospital Dr
Ste B
Wetumpka, AL 36092
Phone (334) 567-4311

500 Hospital Dr
Wetumpka, AL 36092
Phone (334) 283-2542

Interoperability endpoints

  • Direct secure messaging: jsloan@direct.mhg.com

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1790724276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863535",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863535",
            "telephone_number": "904-805-1300",
            "fax_number": "904-805-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MEDICAL PARK DR",
            "city": "ATMORE",
            "state": "AL",
            "postal_code": "365023006",
            "telephone_number": "904-805-1300",
            "fax_number": "904-805-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOAN",
        "first_name": "JEFFREY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "14752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51521952",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atmore, AL

Sources for this page

Verify at the official NPI Registry.