Elite Professional Providers, LLC
NPI 1891488433ActiveOrganization· Family Medicine· Springfield, MO
Family Medicine in Springfield, Missouri, registered in NPPES in May 2023. The authorized official on file is Shawn Kelley, Coo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1891488433 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 30, 2023 |
| Last updated in NPPES | Jul 7, 2026 |
| Certified by provider | Jul 7, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Nurse Practitioner, Family | 363LF0000X | — | — |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MO) |
|---|
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