Premier Endocrinology PLLC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

ME109189 Issued in FL

Legal business name

PREMIER ENDOCRINOLOGY PLLC

Practice address

3004 17TH St
Saint Cloud, FL 34769-6011

Phone

(407) 593-2910

Fax

(407) 593-2913

NPI assigned

Dec 13, 2011

Last updated

Jul 28, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Theresa Adadzewa Fynn, MDNPI 1669639266

Title

Owner

Phone

(407) 593-2910

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FBFHBA

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Theresa Adadzewa Fynn, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Saint Cloud, FL
  • NPI 1669639266
  Medicare reassignment Care Compare group NPD Authorized official
• Mustafa Kinaan

  • Endocrinology, Diabetes & Metabolism Physician
  • Saint Cloud, FL
  • NPI 1548675655

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Kwame Safo Ntim, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Saint Cloud, FL
  • NPI 1194926501
  Medicare reassignment Care Compare group NPD
• Dionardo Medina Encarnacion, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Wilkes Barre, PA
  • NPI 1972733699

  FL

  Medicare reassignment Care Compare group NPD
• Yolanda M Palmero, RNP

  • Primary Care Nurse Practitioner
  • Saint Cloud, FL
  • NPI 1700359734
  Medicare reassignment NPD
• Erich Tyrone Wyckoff, MD

  • Obstetrics & Gynecology Physician
  • Gainesville, FL
  • NPI 1811965155
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595894400000",
    "number": "1033487426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 17TH ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696011",
            "telephone_number": "407-593-2910",
            "fax_number": "407-593-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 17TH ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696011",
            "telephone_number": "407-593-2910",
            "fax_number": "407-593-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ENDOCRINOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-13",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A",
        "authorized_official_last_name": "FYNN",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "ADADZEWA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-593-2910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME109189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12316257",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Positive Mindset Group
• Ann Elizabeth Powers
• Charles Powers, M.D.
• Lakin Pratt, RBT
• Precision Surgicenter of Saint Cloud
• Premier Life Health Services, LLC (Premier Healthcare of Florida)
• Premier Med PA
• Premise Health of Florida Medical PA (City of St Cloud)
• Prescriptions Unlimited Sdoc
• Prestige Support Services Inc

• Endocrinology, Diabetes & Metabolism Physician in Saint Cloud, FL
• Providers in Saint Cloud, FL by specialty
• Endocrinology, Diabetes & Metabolism Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.