Elite Anti-Aging and Vein Clinic

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

2007030787 Issued in MO

Legal business name

ELITE ANTI-AGING AND VEIN CLINIC

Doing business as

Elite Vein Clinic

Practice address

5400 N Oak Trfy
Suite 115
Kansas City, MO 64118-4688

Phone

(816) 453-0017

Fax

(816) 453-0018

NPI assigned

Sep 3, 2008

Organization subpart

No

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

Authorized official

Name

Harold Albert Johnson, MD

Title

Owner

Phone

(816) 453-0017

Specialties & licenses 1

Addresses

Other names 1

• Elite Vein Clinic Doing business as

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220400000000",
    "number": "1922256072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 901480",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641901480",
            "telephone_number": "816-453-0017",
            "fax_number": "816-453-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 N OAK TRFY",
            "address_2": "SUITE 115",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641184688",
            "telephone_number": "816-453-0017",
            "fax_number": "816-453-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE ANTI-AGING AND VEIN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "ALBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-453-0017",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MO",
            "license": "2007030787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Vein Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elephant Foot ABA, LLC
• Elevate Life Chiropractic and Wellness LLC
• Elevating Care Clinic, LLC
• Brock Elgin, DC
• Elise J Chapline Psychotherapy Services LLC
• Elite Care Services, LLC
• Elite Cares's Service
• Elite Chiropractic Clinic Inc
• Elite Home Healthcare Services, Inc.
• Elitecare Home Health Services, LLC

• Ambulatory Surgical Clinic/Center in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Ambulatory Surgical Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; 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.