NPIMap

Organization Active NPI

Elite Healthcare Physical Medicine, LLC

  • Physical Medicine & Rehabilitation Physician
  • Mount Pleasant, SC
National Provider Identifier
1245697424
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
ELITE HEALTHCARE PHYSICAL MEDICINE, LLC
Practice address
1300 Hospital Dr
Suite 220
Mount Pleasant, SC 29464-3261
Phone
(305) 915-1249
NPI assigned
Jan 19, 2016
Last updated
Jan 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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

Authorized official

Name
Dr. Todd James Brown, DCNPI 1588897680
Title
Owner
Phone
(305) 915-1249

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

1300 Hospital Dr
Suite 220
Mount Pleasant, SC 29464-3261

Mailing address

1300 Hospital Dr
Suite 220
Mount Pleasant, SC 29464-3261
Phone (305) 915-1249

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160606000815 SC Part B Supplier - Clinic/Group Practice 3577853449 Receives reassigned benefits from 8 practitioners
Practice locations: Mount Pleasant, SC
O20170109003267 SC DME Supplier - Physician - General Practice 3577853449 Practice locations: Mount Pleasant, SC

National Provider Directory

National Provider Directory

Locations

1300 Hospital Dr
Ste 220
Mt Pleasant, SC 29464
Phone (843) 881-5773

Practitioners & affiliated clinicians

Practitioners 9

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": "1453161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453161600000",
    "number": "1245697424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 HOSPITAL DR",
            "address_2": "SUITE 220",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643261",
            "telephone_number": "305-915-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 HOSPITAL DR",
            "address_2": "SUITE 220",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643261",
            "telephone_number": "305-915-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE HEALTHCARE PHYSICAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-19",
        "last_updated": "2016-01-19",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-915-1249",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.