Elite Provider Group PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ELITE PROVIDER GROUP PC

Practice address

1096 S Belsay Rd Ste C
Burton, MI 48509-1948

Phone

(810) 743-3351

NPI assigned

Jun 20, 2025

Organization subpart

No

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

Authorized official

Name

Crystal Chandler

Title

Manager of Provider Network

Phone

(810) 424-2136

Specialties & licenses 2

Addresses

Tax ID family

Elite Provider Group PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Elite Provider Group PC

  • Internal Medicine Physician
  • Burton, MI
  • NPI 1083501217
  NPD tax ID
• Elite Provider Group PC

  • Family Medicine Physician
  • Clarkston, MI
  • NPI 1093602229
  NPD tax ID
• Elite Provider Group PC

  • Family Medicine Physician
  • Grand Blanc, MI
  • NPI 1205723434
  NPD tax ID

Locations

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

{
    "created_epoch": "1750377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756944000000",
    "number": "1619864840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1096 S BELSAY RD STE C",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091948",
            "telephone_number": "810-743-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PROVIDER GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-20",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "CHANDLER",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "MANAGER OF PROVIDER NETWORK",
        "authorized_official_telephone_number": "810-424-2136"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Edgar
• Daniel Steven Eisinger, DDS
• Michael Duane Eisinger, D.D.S.
• Khaled S El-Ganainy, DC
• Elite Provider Group PC
• Aniya Domynique Ellison
• Abusufian Eltaib Eltahir, B-PHARM
• Engelman Vision Associates PLLC
• Mark D. Engelman, O.D.
• Michael John Engelman, OD

• Family Medicine Physician in Burton, MI
• Providers in Burton, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; 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.