NPIMap

Organization Active NPI

Elite Medical Laboratory LLC

  • Phlebotomy Technician
  • Indianapolis, IN
National Provider Identifier
1902678006
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
Legal business name
ELITE MEDICAL LABORATORY LLC
Practice address
5435 Emerson Way Ste 405a-B
Indianapolis, IN 46226-1466
Phone
(317) 827-0011
NPI assigned
Oct 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Authorized official

Name
Ms. Ronnisha Shaquana Banks, CPT
Title
Owner
Phone
(779) 475-1603

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 246RP1900X Primary

Addresses

Primary practice location

5435 Emerson Way Ste 405a-B
Indianapolis, IN 46226-1466

Mailing address

5435 Emerson Way Ste 405a-B
Indianapolis, IN 46226-1466
Phone (317) 827-0011

National Provider Directory

National Provider Directory

Locations

5435 Emerson Way
Ste 405AB
Indianapolis, IN 46226
Phone (317) 827-0011

NPI Registry JSON

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698019200000",
    "number": "1902678006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5435 EMERSON WAY STE 405A-B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462261466",
            "telephone_number": "317-827-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5435 EMERSON WAY STE 405A-B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462261466",
            "telephone_number": "317-827-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE MEDICAL LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-22",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "RONNISHA",
        "authorized_official_middle_name": "SHAQUANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "779-475-1603",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPT"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.