Premierescan PC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

G59447 Issued in CA

Legal business name

PREMIERESCAN PC

Practice address

2324 Montpelier Dr Ste 7
San Jose, CA 95116-1612

Phone

(669) 263-6344

Fax

(408) 708-4454

NPI assigned

Aug 21, 2006

Last updated

Feb 28, 2018By 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

Brittany Lynn Semides

Title

Director of Operations

Phone

(408) 217-2803

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Gary Michael Kawesch, M.D.

  • Ophthalmology Physician
  • San Jose, CA
  • NPI 1497875025
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519776000000",
    "number": "1083720304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2324 MONTPELIER DR STE 7",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161612",
            "telephone_number": "669-263-6344",
            "fax_number": "408-708-4454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2324 MONTPELIER DR STE 7",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161612",
            "telephone_number": "669-263-6344",
            "fax_number": "408-708-4454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERESCAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2018-02-28",
        "status": "A",
        "authorized_official_last_name": "SEMIDES",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "408-217-2803"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "CA",
            "license": "G59447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Premise Health of California Medical, P.C (Life Connections Health Center)
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• Jeff Andrew Prendergast, LCSW
• Rachel Prentice, M.A

• Radiology Clinic/Center in San Jose, CA
• Providers in San Jose, CA by specialty
• Radiology Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.