Elite Primary Care and TCM Services LLC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

Legal business name

ELITE PRIMARY CARE AND TCM SERVICES LLC

Practice address

4795 Bethlehem Rd Ste G
Richmond, VA 23230-2516

Phone

(804) 467-1628

Fax

(804) 716-1311

NPI assigned

May 29, 2023

Organization subpart

No

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

Authorized official

Name

Angella Russell

Title

Owner

Phone

(804) 467-1628

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1685318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721952000000",
    "number": "1336832229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4795 BETHLEHEM RD STE G",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232302516",
            "telephone_number": "804-467-1628",
            "fax_number": "804-716-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4795 BETHLEHEM RD STE G",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232302516",
            "telephone_number": "804-467-1628",
            "fax_number": "804-716-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PRIMARY CARE AND TCM SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-29",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "ANGELLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-467-1628"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Nurse Practitioner in Richmond, VA
• Providers in Richmond, VA by specialty
• Gerontology Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; 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.