Elite Healthcare Physical Medicine is a medicare enrolled "General Practice" provider in Carrollton, Georgia. Their current practice location is
307 Adamson Sq, Carrollton, Georgia. You can reach out to their office (for appointments etc.) via phone at
(770) 214-9146.
Elite Healthcare Physical Medicine is licensed to practice in Georgia (license number 052922) and it also participates in the medicare program. Elite Healthcare Physical Medicine
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1669736120.
Healthcare Provider's Profile
| Full Name | Elite Healthcare Physical Medicine |
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| Type | Facility |
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| Speciality | General Practice |
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| Location | 307 Adamson Sq, Carrollton, Georgia |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1669736120
- Provider Enumeration Date: 06/29/2012
- Last Update Date: 06/29/2012
Medicare PECOS Information:
- PECOS PAC ID: 8325292212
- Enrollment ID: O20130130000187
Medical Identifiers
Medical identifiers for Elite Healthcare Physical Medicine such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1669736120 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111NR0400X | Chiropractor - Rehabilitation | CHIR007565 (Georgia) | Secondary |
| 208D00000X | General Practice | 052922 (Georgia) | Primary |
| 363LF0000X | Nurse Practitioner - Family | RN148627 (Georgia) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Elite Healthcare Physical Medicine acts as a billing entity for following providers:
| Provider Name | Amy Jordan Eubanks |
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| Provider Type | Practitioner - Internal Medicine |
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| Provider Identifiers | NPI Number: 1962441493
PECOS PAC ID: 2961474861
Enrollment ID: I20040811000372 |
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| Provider Name | Ryan C Weber |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1588791941
PECOS PAC ID: 1850378456
Enrollment ID: I20051007000081 |
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| Provider Name | Julie D Weber |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1841315223
PECOS PAC ID: 0143392399
Enrollment ID: I20080702000474 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Elite Healthcare Physical Medicine is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Elite Healthcare Physical Medicine
307 Adamson Sq,
Carrollton, GA 30117-3213
Ph: (770) 214-9146 | Elite Healthcare Physical Medicine
307 Adamson Sq,
Carrollton, GA 30117-3213
Ph: (770) 214-9146 |
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