Elite Wellness

Primary specialty

NutritionistTaxonomy code 133N00000X

Legal business name

ELITE WELLNESS

Doing business as

Elite Wellness

Practice address

18 Hyde Park Ave
Suite 4
Jamaica Plain, MA 02130-4163

Phone

(617) 522-4397

NPI assigned

Jul 17, 2009

Organization subpart

No

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

Authorized official

Name

Mishell Ronica Brookins

Title

President

Phone

(617) 522-4397

Specialties & licenses 1

Addresses

Other names 1

• Elite Wellness Doing business as

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

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247788800000",
    "number": "1568692135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 HYDE PARK AVE",
            "address_2": "SUITE 4",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304163",
            "telephone_number": "617-522-4397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 HYDE PARK AVE",
            "address_2": "SUITE 4",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304163",
            "telephone_number": "617-522-4397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-17",
        "last_updated": "2009-07-17",
        "status": "A",
        "authorized_official_last_name": "BROOKINS",
        "authorized_official_first_name": "MISHELL",
        "authorized_official_middle_name": "RONICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-522-4397"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nutritionist in Jamaica Plain, MA
• Providers in Jamaica Plain, MA by specialty
• Nutritionist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2009; 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.