NPIMap

Organization Active NPI

Elite Medical Associates, PLLC

  • Family Medicine Physician
  • Coopersville, MI
National Provider Identifier
1023520681
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ELITE MEDICAL ASSOCIATES, PLLC
Practice address
50 Main St
Coopersville, MI 49404-1231
Phone
(616) 268-9931
NPI assigned
Nov 3, 2017
Last updated
Jun 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Shanae BartlettNPI 1073904983
Title
Administrator
Phone
(248) 388-9212

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

50 Main St
Coopersville, MI 49404-1231

Mailing address

50 Main St
Coopersville, MI 49404-1231
Phone (616) 268-9931

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1509667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1023520681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MAIN ST",
            "city": "COOPERSVILLE",
            "state": "MI",
            "postal_code": "494041231",
            "telephone_number": "616-268-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MAIN ST",
            "city": "COOPERSVILLE",
            "state": "MI",
            "postal_code": "494041231",
            "telephone_number": "616-268-9931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE MEDICAL ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-03",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "BARTLETT",
        "authorized_official_first_name": "SHANAE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "248-388-9212"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coopersville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.