NPIMap

Organization Active NPI

Elite Medical Associates, PC

  • Specialist
  • Hazlehurst, GA
National Provider Identifier
1427237775
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
051068 Issued in GA
Legal business name
ELITE MEDICAL ASSOCIATES, PC
Practice address
143 S Tallahassee St
Hazlehurst, GA 31539-6466
Phone
(912) 375-4400
Fax
(911) 237-5449
NPI assigned
Nov 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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

Authorized official

Name
Dr. Patrick B PullinNPI 1093704397
Title
Office Manager
Phone
(912) 375-4400

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
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 051068 GA Primary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 049936 GA

Addresses

Primary practice location

143 S Tallahassee St
Hazlehurst, GA 31539-6466

Mailing address

PO Box 729
Hazlehurst, GA 31539-0729
Phone (912) 375-4400

Other identifiers 2

IdentifierTypeStateIssuer
362318407AMedicaidGA
455996743AMedicaidGA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1427237775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 729",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315390729",
            "telephone_number": "912-375-4400",
            "fax_number": "912-375-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 S TALLAHASSEE ST",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315396466",
            "telephone_number": "912-375-4400",
            "fax_number": "911-237-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE MEDICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "PULLIN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "912-375-4400",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "051068",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "049936",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362318407A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "455996743A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazlehurst, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.