LAKE RUSSELL SPECIALTY HEALTHCARE SERVICES
NPI 1124488291
Obstetrics & Gynecology in Elberton, GA
About Lake Russell Specialty Healthcare Services NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKE RUSSELL SPECIALTY HEALTHCARE SERVICES (NPI 1124488291) is a healthcare organization registered as an obstetrics & gynecology in Elberton, Georgia and active in the NPI registry since March 2016. The organization holds an CLIA Accreditation certificate valid through March 14, 2027 and lists Brandon Clary, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lake Russell Specialty Healthcare Services is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Lake Russell Specialty Healthcare Services, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (5)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Accreditation 11D0262037
Elbert Memorial Hospital · Elberton, GAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Elbert Memorial Hospital's NPI number?
The NPI number for Elbert Memorial Hospital is 1124488291. It was assigned to this organization in the NPPES registry on March 2, 2016. The provider is doing business as Lake Russell Specialty Healthcare Services.
Where is Elbert Memorial Hospital located?
Elbert Memorial Hospital is located at 46 Laurel Dr, Elberton, GA 30635. The listed phone number is (706) 213-2579.
What is Elbert Memorial Hospital's specialty?
The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.
Is Elbert Memorial Hospital enrolled in Medicare?
Yes. Elbert Memorial Hospital is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Elbert Memorial Hospital?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians, all in General Surgery, reassign their Medicare billing to Elbert Memorial Hospital. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Elbert Memorial Hospital hold a CLIA laboratory certificate?
Yes. A Certificate of Accreditation (number 11D0262037) is associated with this NPI, valid through March 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Elbert Memorial Hospital accept?
Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Elbert Memorial Hospital as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Elbert Memorial Hospital was last updated on March 24, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Lake Russell Specialty Healthcare Services · NPI 1124488291
Obstetrics & Gynecology organization in Elberton, Georgia. Organization record, active in the CMS NPPES registry since March 2, 2016.
## Identity
- **NPI:** 1124488291 (Entity type: Organization)
- **Enumerated:** March 2, 2016
- **Primary specialty:** Obstetrics & Gynecology · taxonomy 207V00000X
- **Legal business name:** Elbert Memorial Hospital
- **Organization subpart:** Yes (part of Elbert Memorial Hospital)
- **Authorized official:** Brandon Clary, CEO
## Practice location
- **Address:** 46 LAUREL DR, Elberton, GA 30635-1842
- **Phone:** (706) 213-2579
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians (General Surgery) reassign Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 24, 2016
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1124488291) · Data from the CMS NPPES public registry.