Elite Healthcare of Mansfield

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ELITE HEALTHCARE OF MANSFIELD

Practice address

1600 Highway 287 N
Suite 104
Mansfield, TX 76063-8853

Phone

(817) 453-5001

NPI assigned

Nov 13, 2006

Organization subpart

No

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

Authorized official

Name

Keith Jensen, D.C.

Title

President

Phone

(817) 453-5001

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Elite Healthcare2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Elite Healthcare

  • Rehabilitation Clinic/Center
  • Mansfield, TX
  • NPI 1215194345
  NPD tax ID

Locations

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1942371687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 HIGHWAY 287 N",
            "address_2": "SUITE 104",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638853",
            "telephone_number": "817-453-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 HIGHWAY 287 N",
            "address_2": "SUITE 104",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638853",
            "telephone_number": "817-453-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE HEALTHCARE OF MANSFIELD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-453-5001",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TX",
            "identifier": "0040EG",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Henry Ehizokhale, PMHNP
• Shafaq Ejaz, M.D.
• Doris Nwamaka Ejimadu
• Brittany Eleam
• Elite Healthcare
• Elite View Imaging, LLC
• Elizabeth S. Maddaford,LCSW,PLLC
• Rachel Elliott
• Kimberly Y Ellis
• Olha Elorreaga, PA-C

• Family Medicine Physician in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.