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Export Provider Record NPI 1134435647
Elite Pediatric And Adolescent Medicine
Organization Subpart: NO
Active
NPI Number1134435647
NPI TypeNPI-2 Organization
SpecialtyPediatrics
Provider Details
NPI1134435647
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2010-08-20
Last Updated2026-04-09
Authorized OfficialDerrick Hamilton
Owner
Phone: 9018138861
Mailing AddressPo Box 538
Somerville, TN 38068-0538
United States
Phone: (901) 813-8861 | Fax: (901) 813-8862
📍 View Map
Primary Practice Address214 Lakeview Rd, Suite 2
Somerville, TN 38068-9737
United States
Phone: (901) 516-4082 | Fax: (901) 516-4092
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes208000000X – PediatricsTN38455
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About NPI 1134435647

Elite Pediatric And Adolescent Medicine is an organization registered in the CMS NPPES NPI Registry with NPI number 1134435647. The primary specialty listed is Pediatrics. The organization is located in Somerville, TN. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2010-08-20. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1134435647?

NPI 1134435647 belongs to Elite Pediatric And Adolescent Medicine, a Pediatrics in Somerville, TN. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1134435647 active?

The current status of NPI 1134435647 in the NPPES registry is Active. The record was last updated on 2026-04-09.

What specialty is NPI 1134435647?

NPI 1134435647 is classified under the taxonomy Pediatrics. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1134435647?

You can verify NPI 1134435647 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1134435647?

The primary practice address on file for NPI 1134435647 is 214 Lakeview Rd, Somerville, TN 38068-9737. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1134435647 issued?

NPI 1134435647 was first issued (enumerated) on 2010-08-20. The NPPES record was last updated on 2026-04-09.

Practice Location Map

Elite Pediatric And Adolescent Medicine is located at 214 Lakeview Rd, Somerville, TN. Use the map below to find directions or verify the practice location.

📍 214 Lakeview Rd, Somerville, TN 38068-9737  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Elite Pediatric And Adolescent Medicine. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1134435647. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Pediatrics38455TN
Data Verified from CMS NPPES Last synced: 2026-07-01 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162