Organization Active NPI

Elite Pediatric Healthcare, LLC

  • Pediatric Nurse Practitioner
  • Brandon, FL
National Provider Identifier
1962000174
Registry record updated May 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
Legal business name
ELITE PEDIATRIC HEALTHCARE, LLC
Practice address
673 S Kings Avenue
Brandon, FL 33511
Phone
(251) 610-5615
NPI assigned
Oct 12, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2021

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

Authorized official

Name
Rhonda Nichols McGrew, APRN, NP-CNPI 1962920298
Title
Nurse Practitioner/Co-Owner
Phone
(251) 610-5615

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0200X Primary

Addresses

Primary practice location

673 S Kings Avenue
Brandon, FL 33511

Mailing address

19046 Bruce B Downs Blvd # 1397
Tampa, FL 33647

National Provider Directory

National Provider Directory

Locations

19046 Bruce B Downs Blvd
Tampa, FL 33647
Phone (504) 300-9377

Practitioners & affiliated clinicians

Practitioners 1

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": "1602460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620432000000",
    "number": "1962000174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19046 BRUCE B DOWNS BLVD # 1397",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "673 S KINGS AVENUE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "33511",
            "telephone_number": "251-610-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PEDIATRIC HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-12",
        "last_updated": "2021-05-08",
        "certification_date": "2021-05-08",
        "status": "A",
        "authorized_official_last_name": "MCGREW",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "NICHOLS",
        "authorized_official_title_or_position": "NURSE PRACTITIONER/CO-OWNER",
        "authorized_official_telephone_number": "251-610-5615",
        "authorized_official_credential": "APRN, NP-C"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2021; 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.