ELITE FAMILY PRACTICE (NPI# 1710236880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710236880 |
| Entity Type | Organization |
| Organization Name | ELITE FAMILY PRACTICE |
| Practice Address |
6126 Prestley Mill Rd Suite H Douglasville GA 30134-5623 |
| Practice Telephone | 6787152993 |
| Practice Fax Number | 6787152827 |
| Mailing Telephone | 6787152993 |
| Mailing Fax Number | 6787152827 |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2012-09-05 |
| Authorized Official Name | DELANIA W MILES (OFFICE MANAGER) |
| Authorized Official Telephone | 6787152993 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | 041745 | GA | Managed Care Organizations |
| Street Address |
6126 PRESTLEY MILL RD SUITE H |
| City | DOUGLASVILLE |
| State | GA |
| Zip Code | 30134-5623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669429353 | Samarpan Inc. | Durable Medical Equipment & Medical Supplies | 6126 Prestley Mill Rd, Unit K, Douglasville, GA 30134-5623 | 2006-05-28 |
| 1225635212 | Crystal Keyonnica Bailey | Nurse Practitioner | 6126 Prestley Mill Rd, Douglasville, GA 30134-5623 | 2020-10-03 |
| 1346678687 | Parikshit Patel | Pharmacist | 6126 Prestley Mill Rd, Douglasville, GA 30134-5623 | 2013-10-24 |
| 1699117473 | Dulari K. Parikh | Pharmacist | 6126 Prestley Mill Rd, Suite K, Douglasville, GA 30134-5623 | 2013-07-22 |
| 1700802089 | Dennis Lee Starkey | Dentist | 6126 Prestley Mill Rd, Suite J, Douglasville, GA 30134-5623 | 2006-07-13 |
| 1215972823 | Valencia R Burruss | Family Medicine | 6126 Prestley Mill Rd, Ste H, Douglasville, GA 30134-5624 | 2006-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851915631 | Lilian Pereira | Nurse Practitioner | Bethesda Medical Group, LLC, 9280 Hwy 5 - Suite D, Douglasville, GA 30134 | 2020-06-08 |
| 1548822901 | Sweet Resolve LLC | Nurse Practitioner | 4318 Ridge Rd, Ste 111 Pmb 1017, Douglasville, GA 30134 | 2019-07-05 |
| 1598328791 | Straight Street Life Center Inc | Case Manager/Care Coordinator | 12461 Veterans Memorial, Douglasville, GA 30134 | 2019-04-15 |
| 1174014930 | Caitlin Waldrip | Chiropractor | 8326a Office Park Dr., Douglasville, GA 30134 | 2018-05-28 |
| 1861901050 | Michelle Denise Winston | Licensed Practical Nurse | 6497 E Strickland, Douglasville, GA 30134 | 2017-09-20 |
| 1518335843 | Willis Anthony Rogers | Durable Medical Equipment & Medical Supplies | 7094 Rose Lake Circle, Douglasville, GA 30134 | 2015-09-03 |
| 1497135131 | Patricia Warren | Social Worker | 8317 Office Park Drive Ste.#e, Douglasville, GA 30134 | 2015-06-08 |
| 1457747321 | Kidz Rock Therapy Services, LLC | Occupational Therapist | 6732 West Spring Street, Douglasville, GA 30134 | 2015-04-08 |
| 1386068476 | Naa Y Oden | Psychologist | 4813 Ridge Rd Ste 111-639, Douglasville, GA 30134 | 2014-02-10 |
| 1467893271 | American Ems | Ambulance | 7240 Bankhead Hwy, Douglasville, GA 30134 | 2013-07-09 |
| Find all providers in zip 30134 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386921310 | Life Care Family Practice | Preferred Provider Organization | 8464 Adair St, Douglasville, GA 30134-1839 | 2011-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811502925 | Global Administrative Solutions, Inc | Preferred Provider Organization | 665 Molly Ln Ste 150, Woodstock, GA 30189-3754 | 2020-09-15 |
| 1710597554 | Healthcare Placement Group, LLC | Preferred Provider Organization | 6751 Macon Rd Ste 6, Columbus, GA 31907-9295 | 2020-08-06 |
| 1285196477 | Nutrition Prescriptions LLC | Preferred Provider Organization | 2670 Miriam Ln, Decatur, GA 30032-5731 | 2019-04-05 |
| 1831622976 | Jencare Neiborhood Medical Center | Preferred Provider Organization | 2209 Brandon Ln Sw, Conyers, GA 30094-5084 | 2017-04-05 |
| 1578003349 | Lrdj LLC | Preferred Provider Organization | 790 Huff Rd Nw Apt 4055, Atlanta, GA 30318-4373 | 2017-02-27 |
| 1659818482 | Three In One Medical | Preferred Provider Organization | 5222 Addison Trl Sw, Lilburn, GA 30047-6670 | 2017-01-31 |
| 1205288164 | Medprime Brookhaven | Preferred Provider Organization | 2 Concourse Pkwy, Suite 100, Atlanta, GA 30328-5371 | 2016-07-04 |
| 1003267352 | New Horizon | Preferred Provider Organization | 6200 Bradley Park Dr, Columbus, GA 31904-3078 | 2016-06-28 |
| 1154796563 | Michelle Woodard M.d LLC | Preferred Provider Organization | 2410 Hog Mountain Rd Ste 303, Watkinsville, GA 30677-4850 | 2015-12-10 |
| 1730553322 | Amanda Kort, LLC | Preferred Provider Organization | 37 West Fairmont Avenue, Savannah, GA 31405 | 2015-11-19 |
| Find all providers with the same taxonomy | ||||
| City | DOUGLASVILLE |
| Zip Code | 30134 |
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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.