JOHN L ELFERVIG M.D. NPI 1619910544

NPI Information

NPI: 1619910544
Provider Name: JOHN L ELFERVIG, M.D.
Classification: Ophthalmology - 207WX0107X
Entity Type: Individual

Specialization: Retina Specialist

PECOS Registration: Yes

Address:
825 RIDGE LAKE BLVD
MEMPHIS, TN
ZIP 38120
Phone: (901) 685-2200
Get Directions

John L Elfervig, M.D. is a retina specialist ophthalmology in Memphis, TN. The provider is an ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. John L Elfervig, M.D. NPI is 1619910544. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

825 RIDGE LAKE BLVD
MEMPHIS, TN
ZIP 38120-411
Phone: (901) 685-2200
Fax: (901) 820-2342

The NPI 1619910544 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/14/2006 and was last updated on 1/15/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207W00000X	Ophthalmology		14866	MISSISSIPPI	No
2	207W00000X	Ophthalmology		R4424	ARKANSAS	No
3	207W00000X	Ophthalmology		MD009929	TENNESSEE	No
4	207WX0107X	Ophthalmology	Retina Specialist	9929	TENNESSEE	Yes
5	207WX0107X	Ophthalmology	Retina Specialist	R4424	ARKANSAS	No
6	207WX0107X	Ophthalmology	Retina Specialist	14866	MISSISSIPPI	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	107447001	MEDICAID	ARKANSAS
2	180024050	OTHER	TENNESSEE	PALMETTO RR MEDICARE
3	P00658339	OTHER	MISSISSIPPI	PALMETTO RR MEDICARE
4	3190249	MEDICAID	TENNESSEE
5	00115592	MEDICAID	MISSISSIPPI
6	202004503	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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