ELITE PRIMARY CARE LLC (NPI# 1669945002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669945002 |
| Entity Type | Organization |
| Organization Name | ELITE PRIMARY CARE LLC |
| Practice Address |
121 Wyatt Dr Ste 3 Las Cruces NM 88005-2960 |
| Mailing Address |
8175 Constitution Rd Las Cruces NM 88007-8984 |
| Practice Telephone | 5753032929 |
| Mailing Telephone | 5759939890 |
| Enumeration Date | 2019-01-08 |
| Last Update Date | 2019-01-08 |
| Authorized Official Name | JAIME SANCHEZ (MEMBER) |
| Authorized Official Telephone | 5759939890 |
| Authorized Official Credential | CNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8175 Constitution Rd, Las Cruces, NM 880078984 | 5753032929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134602022 | Elite Primary Care LLC | Family Medicine | 1490 Forest Hill Blvd, West Palm Beach, FL 33406-6014 | 2018-09-07 |
| 1861732745 | Elite Primary Care LLC | Optometrist | 2690 Madison St, Suite 130, Clarksville, TN 37043-5975 | 2013-02-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Elite Primary Care LLC | 12167 Idalia St, Commerce City, CO 80603 |
| Street Address |
121 WYATT DR STE 3 |
| City | LAS CRUCES |
| State | NM |
| Zip Code | 88005-2960 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649796699 | Medical Assisted Wellness LLC | Nurse Practitioner | 121 Wyatt Dr Ste 3, Las Cruces, NM 88005-2960 | 2017-08-21 |
| 1932747987 | Ellen Ashley Stafford | Nurse Practitioner | 121 Wyatt Dr Ste 3, Las Cruces, NM 88005-2960 | 2019-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871158345 | Raymond Pope Stewart Jr. | Community Health Worker | 9999 W. Amador Avenue, Ste. A, Las Cruces, NM 88005 | 2019-05-09 |
| 1538638481 | Jennifer Mcafee | Social Worker | 3100 Oak St. Las Cruces, Nm, Las Cruces, NM 88005 | 2018-11-21 |
| 1023583226 | Richard Flores | Physical Therapist | 1090 Med Park Dr., Las Cruces, NM 88005 | 2018-10-04 |
| 1558850834 | Connections Therapy, Inc. | Counselor | 225 E Idaho Ave Ste 25, Las Cruces, NM 88005 | 2018-05-02 |
| 1982134771 | Madalyn Elyse Sprague | Behavior Technician | 1007 Ellendale Dr, Las Cruces, NM 88005 | 2017-06-14 |
| 1043766249 | Leandra Gabrielle Abeyta | Registered Nurse | 2363 W University Ave, Las Cruces, NM 88005 | 2016-08-28 |
| 1790172641 | Amistad Milestones LLC | Speech-Language Pathologist | 3100 Oak Street, Las Cruces, NM 88005 | 2015-04-17 |
| 1043628753 | Richael Anne Bouvet-jenkins | Social Worker | 755 W. Hadley Avenue, Las Cruces, NM 88005 | 2014-07-25 |
| 1194133801 | Helena Catalina Melendez | Dental Hygienist | 385 Calle Alegra Blg C, Las Cruces, NM 88005 | 2014-07-25 |
| 1447668256 | Cherie O'dell | Specialist | 1758 Highland Ave, Las Cruces, NM 88005 | 2014-07-24 |
| Find all providers in zip 88005 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114531100 | Anneliese K. Glasgow | Nurse Practitioner | 2515 Tiffany Dr, Las Cruces, NM 88011-0880 | 2020-09-07 |
| 1285272831 | Shannon Vane | Nurse Practitioner | 190 Howard Pl Ste A, Las Cruces, NM 88011-8155 | 2019-12-13 |
| 1992351647 | Rito Nelson Jasmin Daan | Nurse Practitioner | 2502 Velarde Pl, Las Cruces, NM 88011-4313 | 2019-08-16 |
| 1447806047 | Sabrina Nicole Bazan | Nurse Practitioner | 345 N San Pedro St, Las Cruces, NM 88001-3462 | 2019-08-11 |
| 1245798586 | Bernardo Black | Nurse Practitioner | 748 Suzanne Ave, Las Cruces, NM 88005-1298 | 2019-03-05 |
| 1538638267 | Christina Lucero | Nurse Practitioner | 584 Cedardale Loop, Las Cruces, NM 88005-0932 | 2018-11-26 |
| 1174091144 | Thomas Hayth | Nurse Practitioner | 3485 Northrise Dr Ste 1, Las Cruces, NM 88011-6839 | 2018-11-08 |
| 1033611793 | Elsie Creason | Nurse Practitioner | 520 Old Farm Rd, Las Cruces, NM 88005-3862 | 2018-03-08 |
| 1639677289 | Melissa J Cometti | Nurse Practitioner | 2735 Northrise Dr Ste B, Las Cruces, NM 88011-0897 | 2018-01-29 |
| 1063929248 | Melissa Michelle Livingston | Nurse Practitioner | 2100 S Triviz Dr Ste F, Las Cruces, NM 88001-0601 | 2018-01-09 |
| Find all providers in LAS CRUCES | ||||
| City | LAS CRUCES |
| Zip Code | 88005 |
Please comment or provide details below to improve the information on ELITE PRIMARY CARE LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.