Look up the most recent NPI and PECOS records

Jeffrey Mark Elrod

Internal Medicine

Allopathic & Osteopathic Physicians

200 E Chestnut St Ste 303, Louisville, KY 40202-1831

PECOS Enrollment

This provider is enrolled in PECOS as JEFFREY ELROD.

Based on the most recent information from CMS, provider Jeffrey Mark Elrod is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1952445058
Provider Type
Individual
Full Name
Elrod, Jeffrey Mark
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
2/20/2007
Last Updated
1/12/2021

Contact Information

Practice Location

200 E Chestnut St Ste 303, Louisville, KY 40202-1831

(502) 629-5552

(602) 629-3132

Mailing Location

PO Box 950202, Louisville, KY 40295-0202

(502) 969-6552

(502) 969-3799

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 42545 Kentucky
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License R1105 Kentucky

Provider Identifiers

ID	Description	Issuer
ID 200967660	Description Medicaid	Issuer Unlisted Indiana
ID 000026447T	Description Other	Issuer HUMANA - NIS Kentucky
ID 50024311	Description Other	Issuer PASSPORT - NIS Kentucky
ID 6615945	Description Other	Issuer CIGNA - NIS Kentucky
ID 000000620784	Description Other	Issuer ANTHEM - NIS Kentucky
ID 105793	Description Other	Issuer SIHO - NIS Kentucky
ID 00533139	Description Other	Issuer MEDICARE - NIS Kentucky
ID 7100073850	Description Other	Issuer MEDICAID KY (NIS) Kentucky
ID P00745275	Description Other	Issuer RAILROAD MCR KY - NIS Kentucky
ID 3721116000	Description Other	Issuer PASSPORT ADVTG - NIS Kentucky

Jeffrey Mark Elrod

PECOS Enrollment

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