Elite Medical Center LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

ELITE MEDICAL CENTER LLC

Practice address

1515 Smith St Ste a
North Providence, RI 02911-2947

Phone

(401) 490-9550

Fax

(401) 490-9221

NPI assigned

Jan 17, 2022

Organization subpart

No

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

Authorized official

Name

Oluseyi Abioye-Akanji, DNP, FNPNPI 1710309349

Title

Owner

Phone

(401) 490-9550

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 3

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

• Oluseyi G Abioye-Akanji, DNP

  • Family Nurse Practitioner
  • North Providence, RI
  • NPI 1710309349

  RI

  Medicare reassignment NPD Authorized official
• Candace Anne Carmichael

  • Family Nurse Practitioner
  • Lincoln, RI
  • NPI 1811865439

  RI

  Medicare reassignment NPD
• Fatima Khadar, NP

  • Nurse Practitioner
  • Providence, RI
  • NPI 1265612725

  RI

  Medicare reassignment NPD

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642377600000",
    "number": "1902557366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 SMITH ST STE A",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029112947",
            "telephone_number": "401-490-9550",
            "fax_number": "401-490-9221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 SMITH ST STE A",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029112947",
            "telephone_number": "401-490-9550",
            "fax_number": "401-490-9221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-17",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A",
        "authorized_official_last_name": "ABIOYE-AKANJI",
        "authorized_official_first_name": "OLUSEYI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-490-9550",
        "authorized_official_credential": "DNP, FNP"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in North Providence, RI
• Primary Care Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.