NPIMap

Organization Active NPI

Prime Medic Network, PLLC

  • Clinic/Center
  • Cleveland, TX
National Provider Identifier
1114477445
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PRIME MEDIC NETWORK, PLLC
Practice address
211 S College Ave
Cleveland, TX 77327-4503
Phone
(281) 592-8622
Fax
(281) 592-8699
NPI assigned
Oct 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Authorized official

Name
Sreenivasulu Cherlo, MDNPI 1578664116
Title
Owner
Phone
(281) 592-8622

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

211 S College Ave
Cleveland, TX 77327-4503

Mailing address

PO Box 5999
Kingwood, TX 77325-5999
Phone (281) 592-8622

Other identifiers 1

IdentifierTypeStateIssuer
111766506MedicaidTX

Other names 1

  • Prime Medic Urgent Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Prime Medic Network PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476144000000",
    "number": "1114477445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5999",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773255999",
            "telephone_number": "281-592-8622",
            "fax_number": "281-592-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S COLLEGE AVE",
            "city": "CLEVELAND",
            "state": "TX",
            "postal_code": "773274503",
            "telephone_number": "281-592-8622",
            "fax_number": "281-592-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME MEDIC NETWORK, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-11",
        "last_updated": "2016-10-11",
        "status": "A",
        "authorized_official_last_name": "CHERLO",
        "authorized_official_first_name": "SREENIVASULU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-592-8622",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111766506",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prime Medic Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cleveland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; 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.