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ELITE PROVIDER GROUP PC
NPI 1093602229
Family Medicine in Clarkston, MI

Active since June 20, 2025
5900 WALDON RD STE A, CLARKSTON, MI 48346(248) 625-7890 Get Directions Write a Review

NPPES record last updated: September 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 4, 2025, Aug 8, 2025, Jun 20, 2025 (3 updates tracked since 2025).

About Elite Provider Group Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELITE PROVIDER GROUP PC (NPI 1093602229) is a healthcare organization registered as a family medicine in Clarkston, Michigan and active in the NPI registry since June 2025. The organization lists Crystal Chandler, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1093602229
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameELITE PROVIDER GROUP PC
Location Address5900 WALDON RD STE AClarkston, MI 48346-4806
Mailing Address3495 S Center RdBurton, MI 48519-1455
Phone(248) 625-7890
Organization SubpartNo
Authorized OfficialCrystal ChandlerAuthorized Official · (810) 424-2136
Enumeration DateJune 20, 2025
Last NPPES UpdateSeptember 4, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 4, 2025
✔ NPI 1093602229 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedPediatricsTaxonomy 208000000X
5900 WALDON RD STE A, Clarkston, MI 48346
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elite Provider Group PC's NPI number?

The NPI number for Elite Provider Group PC is 1093602229. It was assigned to this organization in the NPPES registry on June 20, 2025.

Where is Elite Provider Group PC located?

Elite Provider Group PC is located at 5900 Waldon Rd Ste A, Clarkston, MI 48346. The listed phone number is (248) 625-7890.

What is Elite Provider Group PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Elite Provider Group PC was last updated on September 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.