Organization Active NPI

Elite Primary Care and Aesthetics LLC

  • Family Nurse Practitioner
  • Suffolk, VA
National Provider Identifier
1053119818
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
ELITE PRIMARY CARE AND AESTHETICS LLC
Practice address
5839 Harbour View Blvd Ste 101
Suffolk, VA 23435-3797
Phone
(757) 355-7244
Fax
(877) 682-6096
NPI assigned
Mar 6, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Authorized official

Name
Mrs. Asia Denise Gordon, NPNPI 1730651282
Title
Nurse Practitioner
Phone
(757) 271-4095

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

5839 Harbour View Blvd Ste 101
Suffolk, VA 23435-3797

Mailing address

5839 Harbour View Blvd Ste 101
Suffolk, VA 23435-3797
Phone (757) 271-4095

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250422001565 VA Part B Supplier - Clinic/Group Practice 3173048261 Receives reassigned benefits from 1 practitioner
Practice locations: Suffolk, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2345051Elite Primary Care and Aesthetics5839 Harbour View Blvd Suite 101, Suffolk, VA 23435Certificate of waiverJun 3, 2028

National Provider Directory

National Provider Directory

Locations

1510 Breezeport Way
Ste 300
Suffolk, VA 23435
Phone (757) 344-7558

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1741219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1053119818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5839 HARBOUR VIEW BLVD STE 101",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353797",
            "telephone_number": "757-271-4095",
            "fax_number": "877-682-6096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5839 HARBOUR VIEW BLVD STE 101",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353797",
            "telephone_number": "757-355-7244",
            "fax_number": "877-682-6096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PRIMARY CARE AND AESTHETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-06",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "ASIA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "757-271-4095",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.