Elite Multi Specialty Clinic, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ELITE MULTI SPECIALTY CLINIC, LLC

Practice address

12501 Prosperity Dr Ste 330
Silver Spring, MD 20904-1655

Phone

(301) 604-4033

Fax

(240) 645-4013

NPI assigned

May 29, 2013

Last updated

Aug 11, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Adaora Perpetua Noummy

Title

President/Owner

Phone

(301) 604-4033

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Kimberley Ann Anderson, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Greenbelt, MD
  • NPI 1922020767
  NPD (past)
• Regina Ejura Ijaja, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Greenbelt, MD
  • NPI 1841823523
  NPD (past)
• Taiye Tokunbo Oni, FNP

  • Family Nurse Practitioner
  • Washington, DC
  • NPI 1932430659
  NPD (past)

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1053758235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 PROSPERITY DR STE 330",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041655",
            "telephone_number": "301-604-4033",
            "fax_number": "240-645-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 PROSPERITY DR STE 330",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041655",
            "telephone_number": "301-604-4033",
            "fax_number": "240-645-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE MULTI SPECIALTY CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-29",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "NOUMMY",
        "authorized_official_first_name": "ADAORA",
        "authorized_official_middle_name": "PERPETUA",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "301-604-4033",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "945614700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kate Elie, LCSW-C
• Eliezer Trybuch DPM,LLC
• Elissa Israel, LLC
• Elite Family Care and Clinic
• Elite Medical Supplies
• Elite Multi Specialty Clinic, LLC
• Elizabeth Mitchell Dugan MD LLC
• Brooke A Ellinger
• Elliot R Goldstein MD & Joel R Schulman MD PA
• Ashley Elliott-Adams

• Primary Care Clinic/Center in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Primary Care Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.