Organization Active NPI

Premier Health Express and Advanced Diagnostics Inc

  • Urgent Care Clinic/Center
  • Columbia, MD
National Provider Identifier
1144718792
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
D0070766 Issued in MD
Legal business name
PREMIER HEALTH EXPRESS AND ADVANCED DIAGNOSTICS INC
Practice address
9710 Patuxent Woods Dr Ste 200
Columbia, MD 21046-3458
Phone
(443) 452-0739
Fax
(443) 200-0233
NPI assigned
Apr 30, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Authorized official

Name
Teresa Richardson
Title
Chief Operations Officer
Phone
(443) 836-5376

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Urgent Care Clinic/Center 261QU0200X D0070766 MD Primary

Addresses

Primary practice location

9710 Patuxent Woods Dr Ste 200
Columbia, MD 21046-3458

Mailing address

9710 Patuxent Woods Dr
Columbia, MD 21046-1526
Phone (443) 899-9525

Other practice location 1

145 Rosewick Corner Pl
La Plata, MD 20646
Phone (443) 899-9525

Other practice location 2

225 Town Square Dr Ste 2
Lusby, MD 20657-6535
Phone (443) 899-9525

Other practice location 3

4821 Allentown Rd
Camp Springs, MD 20746-3933
Phone (443) 899-9525

Other practice location 4

5474 Saint Barnabas Rd
Oxon Hill, MD 20745-3622
Phone (443) 899-9525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180516001164 MD Part B Supplier - Clinic/Group Practice 3870857030 Receives reassigned benefits from 4 practitioners
Practice locations: Lusby, MD; Columbia, MD
O20200728000596 DC Part B Supplier - Clinic/Group Practice 3870857030 Receives reassigned benefits from 4 practitioners
Practice locations: Camp Springs, MD; Oxon Hill, MD

National Provider Directory

National Provider Directory

Locations

4821 Allentown Rd
#12202
Camp Springs, MD 20746
Phone (443) 899-9525

9710 Patuxent Woods Dr
Columbia, MD 21046
Phone (443) 899-9525

145 Rosewick Corner Pl
La Plata, MD 20646
Phone (301) 609-5006

4821 Allentown Rd
Suitland, MD 20746
Phone (443) 899-9525

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

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": "1525046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1144718792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9710 PATUXENT WOODS DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461526",
            "telephone_number": "443-899-9525",
            "fax_number": "443-200-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9710 PATUXENT WOODS DR STE 200",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463458",
            "telephone_number": "443-452-0739",
            "fax_number": "443-200-0233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "145 Rosewick Corner Pl",
            "address_purpose": "LOCATION",
            "city": "La Plata",
            "state": "MD",
            "postal_code": "20646",
            "country_code": "US",
            "telephone_number": "443-899-9525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 Town Square Dr Ste 2",
            "address_purpose": "LOCATION",
            "city": "Lusby",
            "state": "MD",
            "postal_code": "206576535",
            "country_code": "US",
            "telephone_number": "443-899-9525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4821 Allentown Rd",
            "address_purpose": "LOCATION",
            "city": "Camp Springs",
            "state": "MD",
            "postal_code": "207463933",
            "country_code": "US",
            "telephone_number": "443-899-9525",
            "fax_number": "833-230-1191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5474 Saint Barnabas Rd",
            "address_purpose": "LOCATION",
            "city": "Oxon Hill",
            "state": "MD",
            "postal_code": "207453622",
            "country_code": "US",
            "telephone_number": "443-899-9525",
            "fax_number": "833-230-1191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREMIER HEALTH EXPRESS AND ADVANCED DIAGNOSTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-30",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "443-836-5376"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "MD",
            "license": "D0070766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.