Active NPI
John Frederick Elder, M.D.
- Obstetrics & Gynecology Physician
- Athens, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 020098
- Practice address
- 1199 Prince Ave
Athens, GA 30606-2797 - Phone
- (706) 475-7000
- Fax
- (706) 475-6676
- NPI assigned
- Dec 20, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 020098 | GA | Primary |
Addresses
Primary practice location
1199 Prince Ave
Athens, GA 30606-2797
Mailing address
700 Sunset Dr
Suite 601
Athens, GA 30606-2293
Phone (706) 548-4754
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000188108B | Medicaid | GA |
Medicare participation
Medicare enrollment files- 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: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020098 | GA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southside Medical Center, Inc. | Current | Accepting new patients | |
| Southside Medical Center, Inc | Current | Accepting new patients | |
| Piedmont Athens Hospitalist Physicians LLC | Current | Accepting new patients | |
| Obhg Georgia, P.C. | Obstetrics & Gynecology | Current | Accepting new patients |
Locations
1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520
1230 Baxter St
Athens, GA 30606
Phone (706) 364-3100
1039 Ridge Ave SW
Atlanta, GA 30315
Phone (407) 761-8640
1035 Red Bud Rd NE
Calhoun, GA 30701
Phone (706) 602-7800
1514 Vernon Rd
Lagrange, GA 30240
Phone (706) 812-2369
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.
-
- Obstetrics & Gynecology Physician
- Athens, GA
- NPI 1750686838
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1578079000
-
- Federally Qualified Health Center (FQHC)
- Atlanta, GA
- NPI 1235123993
-
- Federally Qualified Health Center (FQHC)
- Jonesboro, GA
- NPI 1821981234
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518566400000",
"number": "1992781132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 SUNSET DR",
"address_2": "SUITE 601",
"city": "ATHENS",
"state": "GA",
"postal_code": "306062293",
"telephone_number": "706-548-4754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1199 PRINCE AVE",
"city": "ATHENS",
"state": "GA",
"postal_code": "306062797",
"telephone_number": "706-475-7000",
"fax_number": "706-475-6676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDER",
"first_name": "JOHN",
"middle_name": "FREDERICK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-20",
"last_updated": "2018-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "GA",
"license": "020098",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000188108B",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Athens, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2018; 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.