Eliza A Myers, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DN013940 Issued in GA

Practice address

100 Myrtle Blvd
East Central Regional Hospital
Gracewood, GA 30812

Phone

(706) 790-2144

Fax

(706) 790-2326

NPI assigned

May 6, 2010

Last updated

Aug 5, 2010By the provider in NPPES

Sex

Female

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

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1273104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1962720664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MYRTLE BLVD",
            "address_2": "EAST CENTRAL REGIONAL HOSPITAL",
            "city": "GRACEWOOD",
            "state": "GA",
            "postal_code": "30812",
            "telephone_number": "706-790-2144",
            "fax_number": "706-790-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MYRTLE BLVD",
            "address_2": "EAST CENTRAL REGIONAL HOSPITAL",
            "city": "GRACEWOOD",
            "state": "GA",
            "postal_code": "30812",
            "telephone_number": "706-790-2144",
            "fax_number": "706-790-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "ELIZA",
        "middle_name": "A",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-06",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN013940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gail Cole Jackson, M.D.
• Cynthia Bass Kucela, RPH
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• Melissa B Lynch
• Marla Marie Mitcham, PHARMD
• Holli E Pender, PHARMD.
• Sopheap Pin, PHARMD
• Martin Saumweber Jr., M.D.
• Denise W Smith, M.D.

• Dentist in Gracewood, GA
• Providers in Gracewood, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; 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.