Elite Sports Medicine

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ELITE SPORTS MEDICINE

Practice address

2085 Hamilton Creek Pkwy
Ste 160
Dacula, GA 30019

Phone

(770) 271-1488

Fax

(770) 271-1822

NPI assigned

Jul 31, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Steven Ray Hatfield, DPT ATCNPI 1073617163

Title

Physical Therapist President

Phone

(770) 271-1488

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 3

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

• Steven Ray Hatfield, DPT ATC

  • Physical Therapist
  • Dacula, GA
  • NPI 1073617163
  Medicare reassignment NPD Authorized official
• Makayla Forrest Mangram, ATC

  • Athletic Trainer
  • Dacula, GA
  • NPI 1477138105
  NPD
• Justin Wayne Long, MPT

  • Physical Therapist
  • Dacula, GA
  • NPI 1184728263
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363219200000",
    "number": "1861408239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 HAMILTON CREEK PKWY",
            "address_2": "STE 160",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "30019",
            "telephone_number": "770-271-1488",
            "fax_number": "770-271-1822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 HAMILTON CREEK PKWY",
            "address_2": "STE 160",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "30019",
            "telephone_number": "770-271-1488",
            "fax_number": "770-271-1822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2013-03-14",
        "status": "A",
        "authorized_official_last_name": "HATFIELD",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST PRESIDENT",
        "authorized_official_telephone_number": "770-271-1488",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7758698",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "5620519",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "692612",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ehi Pharmacy Solutions, LLC.
• David Samuel Eisner, M. D.
• Kanayochukwu I Eke, PHARMD
• Chioma Chinonyerem Ekwueme, MD
• Elev8 Movement LLC
• Casey Jones Elliott, FNP
• Harleigh Nicole Embrey, SLP
• Michelle KN Ennis
• Sonia Eno
• Epic Family and Community Services Limited

• Physical Therapist in Dacula, GA
• Providers in Dacula, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; 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.