Elite Orthopedic Surgery and Sports Medicine

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

Legal business name

ELITE ORTHOPEDIC SURGERY AND SPORTS MEDICINE

Practice address

980 E 800 N Ste 104
Orem, UT 84097-4261

Phone

(801) 252-4888

Fax

(801) 252-4887

NPI assigned

Nov 17, 2021

Organization subpart

No

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

Authorized official

Name

Matthew PoulsenNPI 1881635761

Title

Owner

Phone

(801) 252-4888

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Poulsen

  • Orthopaedic Surgery Physician
  • Orem, UT
  • NPI 1881635761
  Medicare reassignment NPD Authorized official
• Landry Thompson

  • Physician Assistant
  • Orem, UT
  • NPI 1629751920
  Medicare reassignment

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637107200000",
    "number": "1710644463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1169",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840111169",
            "telephone_number": "801-252-4888",
            "fax_number": "801-252-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 E 800 N STE 104",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840974261",
            "telephone_number": "801-252-4888",
            "fax_number": "801-252-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE ORTHOPEDIC SURGERY AND SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A",
        "authorized_official_last_name": "POULSEN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-252-4888"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elevate Chiropractic
• Elevate Sports Medicine Inc
• Adam Mohsin Elhaddi, M.D.
• Justin R Eliason, PHARMD
• Elite Anesthesia Associates
• Brinlee Shay Eller
• Betty Ann Elliott, CNM
• Jacquelyn Elliott
• Seth Elliott
• Elena Ellis

• Sports Medicine (Orthopaedic Surgery) Physician in Orem, UT
• Providers in Orem, UT by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.