NPIMap

Organization Active NPI

Elite Rehab and Weightloss

  • Chiropractor
  • Morrow, GA
National Provider Identifier
1083074090
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR006798 Issued in GA
Legal business name
ELITE REHAB AND WEIGHTLOSS
Practice address
1544 Southlake Pkwy
Suite 9D
Morrow, GA 30260-3025
Phone
(678) 469-5011
NPI assigned
Mar 3, 2016
Last updated
Mar 3, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Authorized official

Name
Enna Cull
Title
Ceo
Phone
(678) 469-5011

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CHIR006798 GA Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CHIR006852 GA

Addresses

Primary practice location

1544 Southlake Pkwy
Suite 9D
Morrow, GA 30260-3025

Mailing address

45 Fairway Ridge Dr
Johns Creek, GA 30022-5421

National Provider Directory

National Provider Directory
Tax ID family
Elite Rehab and Weightloss2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456963200000",
    "number": "1083074090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 FAIRWAY RIDGE DR",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300225421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1544 SOUTHLAKE PKWY",
            "address_2": "SUITE 9D",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302603025",
            "telephone_number": "678-469-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE REHAB AND WEIGHTLOSS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-03",
        "status": "A",
        "authorized_official_last_name": "CULL",
        "authorized_official_first_name": "ENNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-469-5011"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR006798",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR006852",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrow, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.