NPIMap

Organization Active NPI

Elite Surgical Assisting LLC

  • Surgical Physician Assistant
  • Conyers, GA
National Provider Identifier
1427440015
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Legal business name
ELITE SURGICAL ASSISTING LLC
Practice address
2442 Planters Mill Way
Conyers, GA 30012-3691
Phone
(214) 227-2457
Fax
(214) 764-0880
NPI assigned
Feb 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Authorized official

Name
Bradford A Joseph, CSFANPI 1386063832
Title
Owner
Phone
(770) 899-4908

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X Primary

Addresses

Primary practice location

2442 Planters Mill Way
Conyers, GA 30012-3691

Mailing address

PO Box 1013
Conyers, GA 30012-1013
Phone (770) 899-4908

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1424304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1427440015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1013",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300121013",
            "telephone_number": "770-899-4908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2442 PLANTERS MILL WAY",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123691",
            "telephone_number": "214-227-2457",
            "fax_number": "214-764-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE SURGICAL ASSISTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-19",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-899-4908",
        "authorized_official_credential": "CSFA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.