ELITE PROFESSIONAL PROVIDERS, LLC – NPI #1891488433
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Health Care Provider Taxonomy Code for Family Medicine

ELITE PROFESSIONAL PROVIDERS, LLC is a provider located in SPRINGFIELD, MO. NPPES has assigned the NPI number 1891488433 to ELITE PROFESSIONAL PROVIDERS, LLC on May 30, 2023. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 2 years ago on Jan 22, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ELITE PROFESSIONAL PROVIDERS, LLC below.

NPI Profile for
ELITE PROFESSIONAL PROVIDERS, LLC

NPI Number
1891488433
Enumeration Date

(more than 3 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ELITE PROFESSIONAL PROVIDERS, LLC
Primary location
3322 S CAMPBELL AVE STE T-1
SPRINGFIELD, MO 65807-4980
Phone: (417) 220-4482 Fax: (417) 414-0017
Mailing address
2135 E INDEPENDENCE ST # 1093
SPRINGFIELD, MO 65804-3749
Phone: (417) 220-4482 Fax: (417) 414-0017
Organization Subpart
No
Authorized Official
SHAWN KELLEY
COO
Phone: (417) 220-4482
Updated
Certification Date
Jan 22, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for ELITE PROFESSIONAL PROVIDERS, LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidMO500128969
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)
363LP0808X
- Nurse Practitioner / Psychiatric/Mental Health
363LF0000X
- Nurse Practitioner / Family

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.