Elite Pediatric Solutions LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ELITE PEDIATRIC SOLUTIONS LLC

Practice address

97 Hughes Rd Ste H
Madison, AL 35758-3401

Phone

(662) 760-6138

NPI assigned

Dec 11, 2024

Last updated

Jan 10, 2025By 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

Pamela P Van Etten

Title

Director of Credentialing

Phone

(334) 799-5853

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 4

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.

• Sarah Faith Hill Bonner, PT

  • Physical Therapist
  • Madison, AL
  • NPI 1821734823
  Medicare reassignment NPD
• Clint D Mann, DPT

  • Physical Therapist
  • Montgomery, AL
  • NPI 1124348875
  Medicare reassignment NPD
• Randall Alan Ransom Jr., DPT

  • Physical Therapist
  • Auburn, AL
  • NPI 1306124151
  Medicare reassignment NPD
• Justin B Crain, RPT

  • Physical Therapist
  • Tallassee, AL
  • NPI 1790721363
  NPD

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

{
    "created_epoch": "1733875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736467200000",
    "number": "1700693041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 HUGHES RD STE H",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357583401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 HUGHES RD STE H",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357583401",
            "telephone_number": "662-760-6138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PEDIATRIC SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-11",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A",
        "authorized_official_last_name": "VAN ETTEN",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "334-799-5853"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Nicole Elam
• Patricia Elizabeth Elder
• Elderride
• Joan Eldridge, NURSE PRACTITIONER
• Elite Group Solutions, LLC
• Elite Podiatry Inc
• Elizabeth Webb, LLC
• Hally B. Elliot, LICSW
• Tresa L Elliott, PH D
• Deloria Jean Ellis, ALC

• Physical Therapist in Madison, AL
• Providers in Madison, AL by specialty
• Physical Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.