Elite Healthcare Physical Medicine

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

052922 Issued in GA

Legal business name

ELITE HEALTHCARE PHYSICAL MEDICINE

Practice address

307 Adamson SQ
Carrollton, GA 30117-3213

Phone

(770) 214-9146

Fax

(770) 214-9166

NPI assigned

Jun 29, 2012

Last updated

Jun 29, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ryan C WeberNPI 1588791941

Title

Owner

Phone

(770) 214-9146

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 3

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.

• Ryan Christopher Weber, D.C.

  • Rehabilitation Chiropractor
  • Carrollton, GA
  • NPI 1588791941
  Medicare reassignment Care Compare group Authorized official
• Julie Dorsch Weber, FNP-C

  • Family Nurse Practitioner
  • Carrollton, GA
  • NPI 1841315223
  Medicare reassignment Care Compare group
• Amy Jordan Eubanks, M.D.

  • Internal Medicine Physician
  • Bremen, GA
  • NPI 1962441493
  Medicare reassignment

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340928000000",
    "number": "1669736120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 ADAMSON SQ",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173213",
            "telephone_number": "770-214-9146",
            "fax_number": "770-214-9166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 ADAMSON SQ",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173213",
            "telephone_number": "770-214-9146",
            "fax_number": "770-214-9166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE HEALTHCARE PHYSICAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-29",
        "last_updated": "2012-06-29",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-214-9146",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "GA",
            "license": "CHIR007565",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "GA",
            "license": "052922",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN148627",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chase Ross Edmonds, APC
• Alanna Edwards, O.D.
• Shatia Edwards, DO
• Ashlynn Deese Eison, M. ED., CCC-SLP
• Mohamed Elgabrouny, DDS
• Meredith Jane Ellis, APC, LPC
• Holly Ely, CRNA
• Enchantment Nursing
• Kayla England, PMH NP
• Kathryn Grace Entrekin

• General Practice Physician in Carrollton, GA
• Providers in Carrollton, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; 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.