NPIMap

Organization Active NPI

Premise Health of Alabama Medical PC

  • Multi-Specialty Clinic/Center
  • Prattville, AL
National Provider Identifier
1104284405
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PREMISE HEALTH OF ALABAMA MEDICAL PC
Practice address
100 Jensen Rd
Prattville, AL 36067-4868
Phone
(334) 361-5568
Fax
(334) 365-5623
NPI assigned
Feb 2, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Authorized official

Name
Jon Leizman, MD
Title
President
Phone
(216) 479-9063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

100 Jensen Rd
Prattville, AL 36067-4868

Mailing address

5500 Maryland Way Ste 120
Brentwood, TN 37027-4993
Phone (334) 361-5568

Other names 1

  • IP Prattville Mill Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Healthworks Medical Group of Alabama P C33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

Locations

100 Jensen Rd
Prattville, AL 36067
Phone (334) 361-5568

NPI Registry JSON

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758672000000",
    "number": "1104284405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY STE 120",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274993",
            "telephone_number": "334-361-5568",
            "fax_number": "334-365-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JENSEN RD",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360674868",
            "telephone_number": "334-361-5568",
            "fax_number": "334-365-5623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF ALABAMA MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-02",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-479-9063",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IP Prattville Mill Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "IP Prattville Mill Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prattville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; 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.