Elvin Coy Irvin Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

78392 Issued in GA

Practice address

915 Gordon Ave
Thomasville, GA 31792-6614

Phone

(229) 228-2000

NPI assigned

Nov 18, 2005

Last updated

Sep 10, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL, AL, SC, TX4 enrollments

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 4

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elvin.irvin.1@27478.direct.athenahealth.com
• FHIR API: https://fhir-myrecord.cerner.com/r4/148f5931-d9cf-4d65-8c66-7021ed161b73/

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.

• Jay Hospital, Inc.

  • Emergency Medicine Physician
  • Jay, FL
  • NPI 1518071562
  Medicare reassignment NPD
• McLeod Regional Medical Center of the Pee Dee, Inc

  dba Cbo MRMC Emergency

  • Emergency Medical Services (Emergency Medicine) Physician
  • Florence, SC
  • NPI 1154371433

  Family Medicine

  Medicare reassignment NPD
• Physician Services Group of Florida, LLC

  • Family Medicine Physician
  • Gulf Breeze, FL
  • NPI 1235775396
  Medicare reassignment NPD
• Poarch Band of Creek Indians

  dba Poarch Creek Indian Health Department

  • Federally Qualified Health Center (FQHC)
  • Atmore, AL
  • NPI 1902916489

  TX

  Medicare reassignment NPD
• Psgfl MSSP, LLC

  • Multi-Specialty Clinic/Center
  • Gulf Breeze, FL
  • NPI 1689557936
  Medicare reassignment NPD (past)
• Jay Hospital, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Jay, FL
  • NPI 1770681421
  NPD
• Sage Health Alabama LLC

  • Primary Care Clinic/Center
  • Mobile, AL
  • NPI 1063123602
  NPD
• Baptist Health Care, Inc

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1700979465
  NPD (past)
• Gulf Coast Family Medicine PLLC

  • Family Medicine Physician
  • Gulf Breeze, FL
  • NPI 1194808188
  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1902888357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 GORDON AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926614",
            "telephone_number": "229-228-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 GORDON AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926614",
            "telephone_number": "229-228-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRVIN",
        "first_name": "ELVIN",
        "middle_name": "COY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME42445",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "33164",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "78392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041748300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF FLORIDA",
            "identifier": "17583",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ALABAMA",
            "identifier": "592-05580",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00686500",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elvin.irvin.p15@direct.archbold.nextgenshare.com",
            "affiliation": "N",
            "address_1": "915 Gordon Ave",
            "city": "Thomasville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "317926614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Regenia Durwood Hutchins, NP
• Sean William Hutchison, M.S., ATC, LAT, CSCS
• Independent Physical Therapy of Ga, LLC
• Indigo Family Health LLC
• Interventional Pain Management of
• Felton Ivey
• Takao Iwano
• J H Harvey Co LLC (Harveys Supermarket Pharmacy #2335)
• Beverly R Jackson, RN ANP
• Courtney D. Jackson, MD

• Family Medicine Physician in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.