Provider Demographics
NPI:1669115622
Name:ELITE SPORTS MEDICINE AND ORTHOPAEDIC CENTER, PLC
Entity type:Organization
Organization Name:ELITE SPORTS MEDICINE AND ORTHOPAEDIC CENTER, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-324-1600
Mailing Address - Street 1:2004 HAYES ST STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2689
Mailing Address - Country:US
Mailing Address - Phone:615-324-1600
Mailing Address - Fax:615-324-1661
Practice Address - Street 1:1001 HEALTH PARK DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5721
Practice Address - Country:US
Practice Address - Phone:615-324-1600
Practice Address - Fax:615-324-1661
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELITE SPORTS MEDICINE AND ORTHOPAEDIC CENTER, PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty