Organization Active NPI

Elevate Medical, LLC

  • Integrative Medicine Physician
  • Dothan, AL
National Provider Identifier
1013696814
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Integrative Medicine PhysicianTaxonomy code 202D00000X
Legal business name
ELEVATE MEDICAL, LLC
Practice address
1491 Hartford Hwy
Dothan, AL 36301-3349
Phone
(334) 673-1488
Fax
(334) 673-8496
NPI assigned
Jul 18, 2023
Last updated
Aug 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ashley Anderson
Title
Case Manager
Phone
(334) 673-1488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Integrative Medicine Physician 202D00000X NU Primary

Addresses

Primary practice location

1491 Hartford Hwy
Dothan, AL 36301-3349

Mailing address

1491 Hartford Hwy
Dothan, AL 36301-3349
Phone (334) 673-1488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240903000240 AL Part B Supplier - Clinic/Group Practice 2961941158 Receives reassigned benefits from 2 practitioners
Practice locations: Dothan, AL

National Provider Directory

National Provider Directory

Locations

1491 Hartford Hwy
Dothan, AL 36301
Phone (334) 673-1488

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724976000000",
    "number": "1013696814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1491 HARTFORD HWY",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013349",
            "telephone_number": "334-673-1488",
            "fax_number": "334-673-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1491 HARTFORD HWY",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013349",
            "telephone_number": "334-673-1488",
            "fax_number": "334-673-8496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATE MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "CASE MANAGER",
        "authorized_official_telephone_number": "334-673-1488"
    },
    "taxonomies": [
        {
            "code": "202D00000X",
            "taxonomy_group": "",
            "desc": "Integrative Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.