Organization Active NPI

Elite Primary Care and Wellness, PLLC

  • Family Medicine Physician
  • Lubbock, TX
National Provider Identifier
1891473088
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ELITE PRIMARY CARE AND WELLNESS, PLLC
Practice address
8713 Milwaukee Ave Ste 100
Lubbock, TX 79424-0927
Phone
(806) 407-5885
Fax
(806) 407-5883
NPI assigned
Jul 7, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Authorized official

Name
Talynn Harvey, PANPI 1497396386
Title
Member
Phone
(432) 559-4329

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X

Addresses

Primary practice location

8713 Milwaukee Ave Ste 100
Lubbock, TX 79424-0927

Mailing address

8713 Milwaukee Ave Ste 100
Lubbock, TX 79424-0927
Phone (806) 407-5885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230817000127 TX Part B Supplier - Clinic/Group Practice 9335501725 Receives reassigned benefits from 2 practitioners
Practice locations: Lubbock, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2288738Elite Primary Care and Wellness, PLLC8713 Milwaukee Ave. Ste. 100, Lubbock, TX 79424Certificate of waiverAug 29, 2027

National Provider Directory

National Provider Directory

Locations

8713 Milwaukee Ave
Ste 100
Lubbock, TX 79424
Phone (806) 407-5885

8713 Milwaukee Ave
Lubbock, TX 79424
Phone (806) 407-5885

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1891473088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8713 MILWAUKEE AVE STE 100",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794240927",
            "telephone_number": "806-407-5885",
            "fax_number": "806-407-5883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8713 MILWAUKEE AVE STE 100",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794240927",
            "telephone_number": "806-407-5885",
            "fax_number": "806-407-5883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PRIMARY CARE AND WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "TALYNN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "432-559-4329",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.