Elite Performance Winston PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

ELITE PERFORMANCE WINSTON PLLC

Practice address

2544 Somerset Center Dr
Winston Salem, NC 27103-6766

Phone

(336) 617-9890

Fax

(336) 955-1964

NPI assigned

Aug 12, 2020

Organization subpart

No

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

Authorized official

Name

Angela Rea

Title

Practice Manager

Phone

(336) 617-8113

Specialties & licenses 1

Addresses

Other names 1

• Elite Performance Chiropractic Doing business as

Locations

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597190400000",
    "number": "1962013102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 WESTRIDGE RD STE 100",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102425",
            "telephone_number": "336-617-8113",
            "fax_number": "336-617-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2544 SOMERSET CENTER DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036766",
            "telephone_number": "336-617-9890",
            "fax_number": "336-955-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PERFORMANCE WINSTON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A",
        "authorized_official_last_name": "REA",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "336-617-8113"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Performance Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.