Gary Newton Elledge, MSN, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN0000014743 Issued in TN

Practice address

1511 Main St
Kimball, TN 37347-5551

Phone

(423) 837-6000

NPI assigned

May 5, 2010

Last updated

May 28, 2010By the provider in NPPES

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

Credentials

Master of Science - Nursing

State licenses

Practice roles

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

• Chastain Family Chiropractic

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  • NPI 1427257740
  NPD (past)
• Jennifer Broyles MD LLC

  • Family Medicine Physician
  • Kimball, TN
  • NPI 1134243017
  NPD (past)

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

{
    "created_epoch": "1273017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275004800000",
    "number": "1831417658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 MAIN ST",
            "city": "KIMBALL",
            "state": "TN",
            "postal_code": "373475551",
            "telephone_number": "423-837-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 MAIN ST",
            "city": "KIMBALL",
            "state": "TN",
            "postal_code": "373475551",
            "telephone_number": "423-837-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLEDGE",
        "first_name": "GARY",
        "middle_name": "NEWTON",
        "credential": "MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-05",
        "last_updated": "2010-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000014743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blair Alysse Bryant, PHARMD
• Rachel Carter, PT
• Jason Ernest Chastain, DC
• Chattanooga Orthopaedic Group, PC (Center for Sports Medicine and Orthopaedics)
• Kelsey E Dent, NP
• Deborah Wyatt Gaddis, NP-C
• Kacie McClendon Hayes, DPT
• Matthew Aaron Holt, PHARM.D.
• Silke Hoosier, FNP
• Jennifer Broyles MD LLC

• Family Nurse Practitioner in Kimball, TN
• Providers in Kimball, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2010; 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.