J B Elliot MD PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

4301047281 Issued in MI

Legal business name

J B ELLIOT MD PC

Practice address

1380 E Main St
Edmore, MI 48829-8339

Phone

(989) 427-3511

NPI assigned

May 10, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jerry Brugler Elliot, M.D.NPI 1427080068

Title

President

Phone

(989) 427-3511

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Jerry Brugler Elliot, M.D.

  • Obstetrics & Gynecology Physician
  • Mt Pleasant, MI
  • NPI 1427080068
  Authorized official Same address or phone

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902856164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 SOUTH DR",
            "address_2": "STE 220",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488583256",
            "telephone_number": "989-773-3411",
            "fax_number": "989-775-3187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 E MAIN ST",
            "city": "EDMORE",
            "state": "MI",
            "postal_code": "488298339",
            "telephone_number": "989-427-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J B ELLIOT MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLIOT",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "BRUGLER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-427-3511",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301047281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Edmore, MI
• Providers in Edmore, MI by specialty
• Obstetrics & Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.