Elite Physical Therapy, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT004868 Issued in GA

Legal business name

ELITE PHYSICAL THERAPY, INC.

Practice address

205 Mercer PL
Homer Road
Commerce, GA 30529-1564

Phone

(706) 335-3816

Fax

(706) 335-3819

NPI assigned

Nov 15, 2006

Last updated

Mar 4, 2009By 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

Mr. Brian Eugene Vandiver, PTNPI 1194805689

Title

PT Co Owner President

Phone

(706) 335-3816

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Brian Eugene Vandiver, PT

  • Physical Therapist
  • Commerce, GA
  • NPI 1194805689
  NPD (past) Authorized official
• David Henry Pate, MSPT, MS, CSCS

  • Physical Therapist
  • Athens, GA
  • NPI 1962582445
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236124800000",
    "number": "1164594859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 MERCER PL",
            "address_2": "HOMER ROAD",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305291564",
            "telephone_number": "706-335-3816",
            "fax_number": "706-335-3819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 MERCER PL",
            "address_2": "HOMER ROAD",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305291564",
            "telephone_number": "706-335-3816",
            "fax_number": "706-335-3819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2009-03-04",
        "status": "A",
        "authorized_official_last_name": "VANDIVER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "PT CO OWNER PRESIDENT",
        "authorized_official_telephone_number": "706-335-3816",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT004868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00981439A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roy E Doss, OD.
• Shelia Doss
• Charles Seidel Dwozan, PT, DPT
• Michael R. Eberhardt, MD
• Edmunds Programs for Human Services Incorporated
• Tabitha Evans, REGISTERED NURSE
• Evernorth Direct Health LLC
• Every Smile Family Dentistry
• Family First Care of Commerce, LLC
• Family Foot Care Center (Jon T. Middleton, DPM, PC)

• Physical Therapist in Commerce, GA
• Providers in Commerce, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; 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.