Elite Primary Care is a medicare enrolled "Family Medicine" provider in Clarksville, Tennessee. Their current practice location is
2690 Madison St, Suite 130, Clarksville, Tennessee. You can reach out to their office (for appointments etc.) via phone at
(931) 245-1701.
Elite Primary Care is licensed to practice in Tennessee (license number DO1638) and it also participates in the medicare program. Elite Primary Care
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 1861732745.
Healthcare Provider's Profile
| Full Name | Elite Primary Care |
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| Type | Facility |
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| Speciality | Family Medicine |
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| Location | 2690 Madison St, Clarksville, Tennessee |
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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: 1861732745
- Provider Enumeration Date: 02/28/2013
- Last Update Date: 06/02/2015
Medicare PECOS Information:
- PECOS PAC ID: 1658516075
- Enrollment ID: O20130405000316
Medical Identifiers
Medical identifiers for Elite Primary Care such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1861732745 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 2297 (Tennessee) | Secondary |
| 207Q00000X | Family Medicine | DO1638 (Tennessee) | Primary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | 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 Primary Care acts as a billing entity for following providers:
| Provider Name | Carlo L Pike |
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| Provider Type | Practitioner - Family Practice |
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| Provider Identifiers | NPI Number: 1700852688
PECOS PAC ID: 5991844755
Enrollment ID: I20091208000463 |
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| Provider Name | Glenda Taylor Atkins |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1972896041
PECOS PAC ID: 4981922796
Enrollment ID: I20161220000565 |
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| Provider Name | Brandy R Robertson |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1427566280
PECOS PAC ID: 5294090817
Enrollment ID: I20180828003133 |
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| Provider Name | Kimberly Dobbyn |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1326635392
PECOS PAC ID: 4385052554
Enrollment ID: I20231106002250 |
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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 Primary Care 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 |
|---|
Elite Primary Care
2690 Madison Street, Suite 130,
Clarksville, TN 37043-0000
Ph: (931) 245-1701 | Elite Primary Care
2690 Madison St, Suite 130,
Clarksville, TN 37043-5975
Ph: (931) 245-1701 |
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