NPIMap

Organization Active NPI

Elite Pain Consultants, PLLC

  • Pain Medicine Physician
  • Cleveland, TN
National Provider Identifier
1497267173
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
ELITE PAIN CONSULTANTS, PLLC
Practice address
102 Dunhill PL NW
Cleveland, TN 37311-3885
Phone
(423) 339-9581
Fax
(423) 472-0454
NPI assigned
Nov 2, 2017
Last updated
Jul 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Authorized official

Name
Cassy Elledge
Title
Revenue Director
Phone
(423) 476-5774

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X NU Primary
Interventional Pain Medicine Physician 208VP0014X NU

Addresses

Primary practice location

102 Dunhill PL NW
Cleveland, TN 37311-3885

Mailing address

102 Dunhill PL NW
Cleveland, TN 37311-3885
Phone (423) 339-9581

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180201001226 TN Part B Supplier - Clinic/Group Practice 4587924014 Receives reassigned benefits from 14 practitioners
Practice locations: Cleveland, TN; Knoxville, TN; Oak Ridge, TN
O20220713003461 GA Part B Supplier - Clinic/Group Practice 4587924014 Receives reassigned benefits from 2 practitioners
Practice locations: Dalton, GA

National Provider Directory

National Provider Directory

Locations

103 Donner Dr
Oak Ridge, TN 37830
Phone (865) 481-3972

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657065600000",
    "number": "1497267173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 DUNHILL PL NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113885",
            "telephone_number": "423-339-9581",
            "fax_number": "423-472-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 DUNHILL PL NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113885",
            "telephone_number": "423-339-9581",
            "fax_number": "423-472-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PAIN CONSULTANTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-02",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A",
        "authorized_official_last_name": "ELLEDGE",
        "authorized_official_first_name": "CASSY",
        "authorized_official_title_or_position": "REVENUE DIRECTOR",
        "authorized_official_telephone_number": "423-476-5774"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; 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.