NPIMap

Organization Active NPI

Elite Medical Services of Georgia

  • Psychiatry Physician
  • Morrow, GA
National Provider Identifier
1700233897
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
65394 Issued in GA
Legal business name
ELITE MEDICAL SERVICES OF GEORGIA
Practice address
1544 Southlake Pkwy
Suite 9D
Morrow, GA 30260-3025
Phone
(470) 878-0696
NPI assigned
May 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Authorized official

Name
Emma Cull
Title
Coo
Phone
(678) 469-5011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 65394 GA Primary

Addresses

Primary practice location

1544 Southlake Pkwy
Suite 9D
Morrow, GA 30260-3025

Mailing address

45 Fairway Ridge Dr
Johns Creek, GA 30022-5421
Phone (678) 469-5011

National Provider Directory

National Provider Directory
Tax ID family
Elite Medical Serives of Georgia2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1544 Southlake Pkwy
Ste 9D
Morrow, GA 30260
Phone (470) 868-0696

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463529600000",
    "number": "1700233897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 FAIRWAY RIDGE DR",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300225421",
            "telephone_number": "678-469-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1544 SOUTHLAKE PKWY",
            "address_2": "SUITE 9D",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302603025",
            "telephone_number": "470-878-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE MEDICAL SERVICES OF GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-18",
        "status": "A",
        "authorized_official_last_name": "CULL",
        "authorized_official_first_name": "EMMA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "678-469-5011"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "65394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrow, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.