Medical Elite Network Corp

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

MEDICAL ELITE NETWORK CORP

Practice address

3277 Summit Glen Dr
Loganville, GA 30052-5398

Phone

(404) 771-8543

NPI assigned

Jan 30, 2023

Organization subpart

No

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

Authorized official

Name

Briouna Richards

Title

Owner

Phone

(404) 771-8543

Specialties & licenses 3

Addresses

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Puzzle Palace Mental and Behavioral Health Services LLC

  • Social Worker
  • Loganville, GA
  • NPI 1326601006
  NPPES parent name

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1346956786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3277 SUMMIT GLEN DR",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300525398",
            "telephone_number": "404-771-8543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3277 SUMMIT GLEN DR",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300525398",
            "telephone_number": "404-771-8543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ELITE NETWORK CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-29",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "BRIOUNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-771-8543"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Loganville, GA
• Providers in Loganville, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.