Douglas H Elleby, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

POD000433 Issued in GA

Practice address

3825 Medical Park Dr.
Ste. 200
Austell, GA 30106-6831

Phone

(770) 745-5101

Fax

(770) 745-9740

NPI assigned

Oct 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Ehi Anesthesia Services, LLC.

  • Anesthesiology Physician
  • Atlanta, GA
  • NPI 1558733139
  NPD (past)
• North Georgia Foot & Ankle Surgery Center, LLC.

  • Ambulatory Surgical Clinic/Center
  • Ringgold, GA
  • NPI 1386692846
  NPD (past)
• Pathology Lab of Georgia, LLC

  • Clinical Medical Laboratory
  • Decatur, GA
  • NPI 1497888499
  NPD (past)
• Surgical Centers of Ga PC

  • Ambulatory Surgical Clinic/Center
  • Macon, GA
  • NPI 1952319378
  NPD (past)

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1871583609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CIRCLE 75 PKWY.",
            "address_2": "STE. 900",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393084",
            "telephone_number": "770-384-0284",
            "fax_number": "404-446-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 MEDICAL PARK DR.",
            "address_2": "STE. 200",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301066831",
            "telephone_number": "770-745-5101",
            "fax_number": "770-745-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLEBY",
        "first_name": "DOUGLAS",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "000433",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD000433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000138993A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1756385",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chibuzor Steve Eke, MBBCH, MPH, MSN, FNP
• Anthony Uba Ekwenchi, MD
• Fedoua Elhilali, PHARMD
• Erin Eliseo
• Elite EMS, LLC
• Bonnie P Ellenoff, DO
• Auburn Kyle Elliott
• Annisha Ellis, MD
• Elvin Home Care Inc
• Em Hearing and Screening

• Podiatrist in Austell, GA
• Providers in Austell, GA by specialty
• Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; 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.