Omni Elite Enterprises, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

OMNI ELITE ENTERPRISES, LLC

Doing business as

Omni Elite Diagnostics

Practice address

4909 Waters Edge Dr Ste 218
Raleigh, NC 27606-2462

Phone

(919) 520-1194

NPI assigned

Jan 8, 2024

Last updated

Jan 8, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

OMNI ELITE ENTERPRISES, LLCAs reported in NPPES

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

Authorized official

Name

Mr. Kerwin Pitttman

Title

Chief Executive Officer

Phone

(919) 520-1194

Specialties & licenses 1

Addresses

Other names 1

• Omni Elite Diagnostics Doing business as

Part of

Omni Elite Enterprises LLC

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704672000000",
    "number": "1467222810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 WATERS EDGE DR STE 218",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276062462",
            "telephone_number": "919-520-1194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4909 WATERS EDGE DR STE 218",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276062462",
            "telephone_number": "919-520-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI ELITE ENTERPRISES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OMNI ELITE ENTERPRISES, LLC",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-05",
        "status": "A",
        "authorized_official_last_name": "PITTTMAN",
        "authorized_official_first_name": "KERWIN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "919-520-1194",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omni Elite Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Omega Independent Living Services, Inc.
• Omega Independent Living Services, Inc.
• Omega Independent Living Services, Inc.
• Omega Mind Behavioral Health
• Jaime Joaquin Alix Omega, NP
• Omni Family of Services North Carolina Inc.
• Omni Family of Services North Carolina Inc.
• Omni Point LLC (Omni Point Medical)
• Omni Visions, Inc
• Omni Visions, Inc.

• Clinical Medical Laboratory in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Medical Laboratory in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; 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.