Elite Medical LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

93-PA21 Issued in NM

Legal business name

ELITE MEDICAL LLC

Practice address

1700 N Union Ave
Roswell, NM 88201-3267

Phone

(575) 623-1303

Fax

(575) 622-1903

NPI assigned

Aug 31, 2012

Last updated

Oct 24, 2019By 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

Barnie P Rodriguez, PANPI 1639395221

Title

Owner

Phone

(575) 623-1303

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 3

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.

• Barnie P. Rodriguez, P.A.

  • Physician Assistant
  • Roswell, NM
  • NPI 1639395221
  Medicare reassignment Care Compare group Authorized official
• Kelly Obrien, ACNP

  • Acute Care Nurse Practitioner
  • Albuquerque, NM
  • NPI 1629701776
  Medicare reassignment Care Compare group NPD
• Joel William Sievers, MD

  • Family Medicine Physician
  • Portales, NM
  • NPI 1538103197
  Medicare reassignment NPD

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

{
    "created_epoch": "1346371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571875200000",
    "number": "1386993764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1974",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882021974",
            "telephone_number": "575-623-1303",
            "fax_number": "575-622-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N UNION AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882013267",
            "telephone_number": "575-623-1303",
            "fax_number": "575-622-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-31",
        "last_updated": "2019-10-24",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "BARNIE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-623-1303",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "93-PA21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Edwards
• Osarobo Ehigiator
• Ahmad El Alayli, M.D.
• Elevate Mobile Rehab, LLC
• Elite Family Services LLC
• Jose Antonio Elizondo Leal, M.D.
• Ellington Counseling Services, LLC
• Ronald E Ellington, LPCC
• Beverley Ann Elliott, M.D.
• Samantha Elmore

• Family Medicine Physician in Roswell, NM
• Providers in Roswell, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.