ELITE MEDICAL GROUP (NPI# 1700147063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700147063 |
| Entity Type | Organization |
| Organization Name | ELITE MEDICAL GROUP |
| Practice Address |
3965 Glen Park Dr Lithonia GA 30038-3692 |
| Practice Telephone | 4045615714 |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2012-06-04 |
| Authorized Official Name | JULIAN SUTER (OWNER) |
| Authorized Official Telephone | 4045615714 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356560999 | Elite Medical Group | Durable Medical Equipment & Medical Supplies | 3002 Gill St, Bloomington, IL 61704-3438 | 2007-04-24 |
| 1497182596 | Elite Medical Group | General Practice | 20265 Valley Blvd Ste E, Walnut, CA 91789-2655 | 2013-10-03 |
| 1023248234 | Elite Medical Group | Family Medicine | 7920 Belt Line Rd, Suite # 120, Dallas, TX 75254-8145 | 2009-07-22 |
| Street Address |
3965 GLEN PARK DR |
| City | LITHONIA |
| State | GA |
| Zip Code | 30038-3692 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225394323 | Np Quality Healthcare, LLC | Clinic/Center | 3965 Glen Park Dr, Lithonia, GA 30038-3692 | 2012-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548814825 | Cynthia Thomas | Nurse's Aide | 5021 Chupp Way, Lithonia, GA 30038 | 2019-07-25 |
| 1558812131 | Fresenius Medical Care Redan, LLC | Clinic/Center | 8425 Mall Parkway, Lithonia, GA 30038 | 2016-10-19 |
| 1730637059 | Flora's Loving Hands | Psychologist | 4891 Eagles Ridge Loop, Lithonia, GA 30038 | 2016-09-15 |
| 1679921886 | Mercy Oyerinde | Nurse Practitioner | 4742 Lanten Court., Lithonia, GA 30038 | 2016-05-27 |
| 1982020996 | Dina Rebecca Smith | Counselor | 6474 Gina Agha Circle, Lithonia, GA 30038 | 2014-03-14 |
| 1164765889 | Kimberly A Weems | Home Health | 6694 Brownsmill Ferry Drive, Lithonia, GA 30038 | 2013-04-01 |
| 1073850988 | Pain and Spine Solutions, LLC | Specialist | 3974 Glen Park Drive, Lithonia, GA 30038 | 2013-01-11 |
| 1629337514 | Fozi Ouse Adem | Pharmacist | 3140 Turner Hill Road, Lithonia, GA 30038 | 2012-05-11 |
| 1043579402 | Elizabeth Anne Berlin | Physician Assistant | 8825 Mall Parkway, Suite 150, Lithonia, GA 30038 | 2012-05-04 |
| 1730467911 | From Our Heart To Your Heart Personal Care Home | Custodial Care Facility | 4485 Idlewood Park, Lithonia, GA 30038 | 2011-07-22 |
| Find all providers in zip 30038 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093345373 | Simon Njelefack Ekokobe | Nurse Practitioner | 1487 Alice Ave, Lithonia, GA 30058-3242 | 2020-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336740398 | Audline Maria Hodnett | Nurse Practitioner | 4805 W Village Way Se Apt 2208, Smyrna, GA 30080-9227 | 2020-11-05 |
| 1073111845 | George Mackel, Pmhnp-bc, LLC | Nurse Practitioner | 12034 Big Canoe, 400 Shetland Trace, Jasper, GA 30143 | 2020-10-14 |
| 1356958060 | Earl Delk | Nurse Practitioner | 3365 Ridgerock Way, Snellville, GA 30078-4176 | 2020-09-26 |
| 1609482991 | Tammy Haskins Bailey | Nurse Practitioner | 196 Laying Farm Rd Se, Milledgeville, GA 31061-9714 | 2020-09-22 |
| 1861007403 | Caring Clinic LLC | Nurse Practitioner | 114 Wrights Dr, Milledgeville, GA 31061 | 2020-09-10 |
| 1376156364 | Katrina Ransom Clark | Nurse Practitioner | 120 Walker Dr Nw, Milledgeville, GA 31061-9561 | 2020-08-28 |
| 1457963746 | Evelyn Ahiante Dennis | Nurse Practitioner | 3325 Emden Ct, Snellville, GA 30039-6047 | 2020-08-19 |
| 1194335620 | Jennifer Logan | Nurse Practitioner | 424 Scotts Way, Augusta, GA 30909-3135 | 2020-08-10 |
| 1750991592 | Jamie Rae Mccracken | Nurse Practitioner | 2538 Gordon Cir Se, Smyrna, GA 30080-8123 | 2020-08-06 |
| 1285244608 | Amcare Substance Abuse and Addiction Counseling | Nurse Practitioner | 3615 Hutchinson Rd Ste 203, Cumming, GA 30040-0501 | 2020-08-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.