NPIMap

Organization Active NPI

Elite Therapy Services, LLC

  • Physical Therapist
  • Fayetteville, GA
National Provider Identifier
1164770434
Registry record updated Feb 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT007563 Issued in GA
Legal business name
ELITE THERAPY SERVICES, LLC
Practice address
125 Commerce Dr
Ste G
Fayetteville, GA 30214-7336
Phone
(678) 545-2530
Fax
(678) 545-2531
NPI assigned
Aug 16, 2012
Last updated
Feb 13, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2014

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

Authorized official

Name
Dr. Yolanda Washington, DPTNPI 1407081664
Title
Owner
Phone
(404) 408-9186

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
Physical Therapist 225100000X PT007563 GA Primary

Addresses

Primary practice location

125 Commerce Dr
Ste G
Fayetteville, GA 30214-7336

Mailing address

125 Commerce Dr
Ste G
Fayetteville, GA 30214-7336
Phone (678) 545-2530

National Provider Directory

National Provider Directory

Locations

125 Commerce Dr
Ste G
Fayetteville, GA 30214
Phone (678) 545-2530

Practitioners & affiliated clinicians

Practitioners 8

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": "1345075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392249600000",
    "number": "1164770434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 COMMERCE DR",
            "address_2": "STE G",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147336",
            "telephone_number": "678-545-2530",
            "fax_number": "678-545-2531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 COMMERCE DR",
            "address_2": "STE G",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147336",
            "telephone_number": "678-545-2530",
            "fax_number": "678-545-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-16",
        "last_updated": "2014-02-13",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "YOLANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-408-9186",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT007563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; 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.