LAKE RUSSELL SPECIALTY HEALTHCARE SERVICES
NPI 1124488291
Obstetrics & Gynecology in Elberton, GA

Active since March 02, 2016CLIA 11D0262037 · Accreditation
46 LAUREL DR, ELBERTON, GA 30635(706) 213-2579 Get Directions Write a Review

NPPES record last updated: March 24, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 24, 2016, Mar 4, 2016 (2 updates tracked since 2016).

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

NPI1124488291
Entity TypeOrganization
Primary Taxonomy207V00000X
Legal Business NameELBERT MEMORIAL HOSPITAL
Location Address46 LAUREL DRElberton, GA 30635-1842
Mailing Address4 Medical DrElberton, GA 30635-1830
Organization SubpartYes
Authorized OfficialBrandon ClaryCeo · (706) 213-2535
Enumeration DateMarch 2, 2016
Last NPPES UpdateMarch 24, 20162 updates tracked since enumeration
NPI 1124488291 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Also ListedOtolaryngologyTaxonomy 207Y00000X
Also ListedSurgeryTaxonomy 208600000X
46 LAUREL DR, Elberton, GA 30635

Other Names 1

Doing Business AsLake Russell Specialty Healthcare Services

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

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, GA
Active · expires Mar 14, 2027
CLIA Number11D0262037
Laboratory TypeHospital
Certificate Effective DateMarch 15, 2025
Certificate Expiration DateMarch 14, 2027
Laboratory DirectorDr. Paul B. Hillesheim
Laboratory Phone(706) 213-2564
Laboratory LocationElbert Memorial Hospital4 Medical Drive, Elberton, GA 30635
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Frequently 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.

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. 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.