NPIMap

Organization Active NPI

Elite Healthcare of Muncie Inc.

  • Family Nurse Practitioner
  • Muncie, IN
National Provider Identifier
1700217189
Registry record updated Feb 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71003894B Issued in IN
Legal business name
ELITE HEALTHCARE OF MUNCIE INC.
Practice address
3417 W Bethel Ave Ste a
Muncie, IN 47304-7504
Phone
(765) 281-8883
Fax
(765) 281-8884
NPI assigned
Dec 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2014

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

Authorized official

Name
Dr. David Segraves
Title
Owner
Phone
(765) 281-8883

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 01027232A IN
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 71003894B IN Primary

Addresses

Primary practice location

3417 W Bethel Ave Ste a
Muncie, IN 47304-7504

Mailing address

3417 W Bethel Ave Ste a
Muncie, IN 47304-7504
Phone (765) 281-8883

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393286400000",
    "number": "1700217189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 W BETHEL AVE STE A",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473047504",
            "telephone_number": "765-281-8883",
            "fax_number": "765-281-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 W BETHEL AVE STE A",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473047504",
            "telephone_number": "765-281-8883",
            "fax_number": "765-281-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE HEALTHCARE OF MUNCIE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-10",
        "last_updated": "2014-02-25",
        "status": "A",
        "authorized_official_last_name": "SEGRAVES",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-281-8883",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01027232A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003894B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; 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.