Elite Sports Medicine Physical Therapy

Primary specialty

Legal MedicineTaxonomy code 173000000X

Legal business name

ELITE SPORTS MEDICINE PHYSICAL THERAPY

Practice address

7125 New Sanger Rd Ste B
Waco, TX 76712-4054

Phone

(254) 754-0375

Fax

(205) 754-2667

NPI assigned

Feb 4, 2011

Organization subpart

No

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

Authorized official

Name

Robert Wolf, MD

Title

President

Phone

(205) 259-3991

Specialties & licenses 1

Addresses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11829/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Kelsy Dieterich, CST/CSFA

  • Surgical Technologist
  • Waco, TX
  • NPI 1639660533
  NPD

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

{
    "created_epoch": "1296777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296777600000",
    "number": "1740586015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7125 NEW SANGER RD STE B",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767124054",
            "telephone_number": "254-754-0375",
            "fax_number": "205-754-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7125 NEW SANGER RD STE B",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767124054",
            "telephone_number": "254-754-0375",
            "fax_number": "205-754-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE SPORTS MEDICINE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-04",
        "last_updated": "2011-02-04",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-259-3991",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Legal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devon Elder, PA-C
• Eyitemi Elete
• Marc Spencer Elieson, MD
• Elite Prosthetics & Orthotics Inc
• Elite Prosthetics, Inc.
• Elite Therapy Services, LLC
• Amy Coyle Elliott, PA
• Cassidy Ellis, OT
• Jon Michael Ellis, M.D.
• Keith Taylor Ellison, M.D.

• Legal Medicine in Waco, TX
• Providers in Waco, TX by specialty
• Legal Medicine in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2011; 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.