Elite Prime Health

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

13630 Issued in TN

Legal business name

ELITE PRIME HEALTH

Practice address

3270 Walton Riverwood LN SE
3056
Atlanta, GA 30339-3561

Phone

(901) 573-7374

NPI assigned

Apr 27, 2017

Organization subpart

No

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

Authorized official

Name

Malinda Conrad, FNP-BCNPI 1922259613

Title

Family Nurse Practitioner

Phone

(901) 573-7374

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Malinda Rochelle Conrad, FNP-BC

  • Family Nurse Practitioner
  • Statesboro, GA
  • NPI 1922259613
  NPD (past) Authorized official

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1396270294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3270 WALTON RIVERWOOD LN SE",
            "address_2": "3056",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393561",
            "telephone_number": "901-573-7374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 WALTON RIVERWOOD LN SE",
            "address_2": "3056",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393561",
            "telephone_number": "901-573-7374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PRIME HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-27",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "CONRAD",
        "authorized_official_first_name": "MALINDA",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "901-573-7374",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "13630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Medical Serives of Georgia
• Elite Minds Peak Performance
• Elite Neurodiagnostics
• Elite Phlebotmy Enterprises L.C
• Elite Phlebotomy Concierge LLC
• Elite Radiology of Georgia, LLC
• Elite Rose Healthcare Services P.C.
• Elite Spectrum Care
• Elite Sport & Personal Injury Centers of Atlanta LLC
• Elite Wound Care LLC

• Family Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.