NPIMap

Organization Active NPI

Elite MRI of Laurens, LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Dublin, GA
National Provider Identifier
1699860130
Registry record updated Oct 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
ELITE MRI OF LAURENS, LLC
Practice address
113 Fairview Park Dr Ste a
Dublin, GA 31021-2563
Phone
(478) 275-8895
Fax
(478) 275-8896
NPI assigned
Oct 3, 2006
Last updated
Oct 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2026

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

Authorized official

Name
Dr. Peter O Holliday III, M.D.
Title
Director
Phone
(478) 314-5009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X Primary

Addresses

Primary practice location

113 Fairview Park Dr Ste a
Dublin, GA 31021-2563

Mailing address

PO Box 4003
Macon, GA 31208-4003
Phone (478) 314-5002

Other identifiers 1

IdentifierTypeStateIssuer
569094754AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070416000290 GA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 7012012321 Practice locations: Dublin, GA

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

113 Fairview Park Dr
Ste A
Dublin, GA 31021
Phone (478) 275-8895

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": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792368000000",
    "number": "1699860130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4003",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312084003",
            "telephone_number": "478-314-5002",
            "fax_number": "478-755-9964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 FAIRVIEW PARK DR STE A",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212563",
            "telephone_number": "478-275-8895",
            "fax_number": "478-275-8896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE MRI OF LAURENS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2026-10-19",
        "certification_date": "2026-10-19",
        "status": "A",
        "authorized_official_last_name": "HOLLIDAY",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "478-314-5009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "569094754A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2026; 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.