Individual provider Active NPI

Elizabeth Londino, M.D.

  • Family Medicine Physician
  • Jackson, TN
National Provider Identifier
1922194778
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD35614 Issued in TN
Practice address
31 Hughes Drive
Jackson, TN 38305
Phone
(731) 668-2800
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD35614 TN Primary

Addresses

Primary practice location

31 Hughes Drive
Jackson, TN 38305

Mailing address

31 Hughes Drive
Jackson, TN 38305

Other identifiers 5

IdentifierTypeStateIssuer
4015060OtherTNBCBS
000000019512OtherTNTLC
3866546MedicaidTN
080174482OtherTNRAILROAD MEDICARE
5647139OtherTNAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20050714000889 TN Practitioner - Family Practice 6204862808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Columbia School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WT Medical AssociatesGroup PAC ID 1951650613, 64 clinicians

Practice addresses (Care Compare)

31 Hughes Dr
Jackson, TN 38305-1505
Phone (731) 668-2800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.74 of 100Reported as apm
Quality
85.23
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD35614TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WT Medical Associates CurrentSince Aug 14, 2023 Accepting new patients
WT Medical Associates CurrentSince Aug 14, 2023 Accepting new patients
Jackson Madison County General Hospital Family Medicine Past Accepting new patients
Mary Immaculate Hospital LLC Past Accepting new patients

Locations

420 Wilkinson Dr
Fl 2
Dyersburg, TN 38024
Phone (731) 285-5133

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

31 Hughes Dr
Jackson, TN 38305
Phone (731) 668-2800

24 Physicians Dr
Jackson, TN 38305
Phone (731) 661-9825

257 Bancorp South Pkwy
Jackson, TN 38305
Phone (731) 512-1283

Interoperability endpoints

  • Direct secure messaging: elondino27743@directepic.wth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1922194778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 HUGHES DRIVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 HUGHES DRIVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305",
            "telephone_number": "731-668-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONDINO",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD35614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4015060",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TLC",
            "identifier": "000000019512",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3866546",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080174482",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5647139",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.