Look up the most recent NPI and PECOS records

Thomas David Elkin

Psychologist

Behavioral Health & Social Service Providers

PECOS Enrollment

This provider is enrolled in PECOS as THOMAS ELKIN.

Based on the most recent information from CMS, provider Thomas David Elkin is legally eligible to order and refer claims for DME services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1588607188
Provider Type
Individual
Full Name
Elkin, Thomas David
Title
Mr.
Credential
PHD

Gender
Male
Sole Proprietor
No
Enumeration Date
6/13/2006
Last Updated
7/5/2012

Contact Information

Practice Location

2500 N State St, Jackson, MS 39216-4500

(601) 984-5888

(601) 984-5842

Mailing Location

2500 N State St, Jackson, MS 39216-4500

(601) 984-5888

(601) 984-5842

Provider Taxonomies

Code	Description	License
Code 103TC0700X Primary	Description Psychologist Behavioral Health & Social Service Providers	License 37-645 Mississippi

Provider Identifiers

ID	Description	Issuer
ID 00121308	Description Medicaid	Issuer Unlisted Mississippi
ID 680012381	Description Other	Issuer RAILROAD MEDICARE Mississippi

Thomas David Elkin

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Cox, Amanda

Burgess, Danny Ray

Schumacher-Coffey, Julie A

Taravella, Cicely C.

Smith, Patrick O

Sutton, Monica J

Voluse, Andrew Craig

Johnson, Phillip

Lyons, Judith

Young, Lashun A.