Primera Wellness LLC

Primary specialty

NutritionistTaxonomy code 133N00000X

Legal business name

PRIMERA WELLNESS LLC

Practice address

1603 Babcock Rd Ste 238-2
San Antonio, TX 78229-4708

Phone

(210) 563-3779

Fax

(951) 462-1161

NPI assigned

Jun 7, 2020

Organization subpart

No

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

Authorized official

Name

Jodi Bennett

Title

Administrator

Phone

(951) 423-2202

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1591488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591488000000",
    "number": "1154945913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6956 INDIANA AVE STE 5",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064109",
            "telephone_number": "951-423-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 BABCOCK RD STE 238-2",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294708",
            "telephone_number": "210-563-3779",
            "fax_number": "951-462-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMERA WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-07",
        "last_updated": "2020-06-07",
        "certification_date": "2020-06-07",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "951-423-2202"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prime Performance DME LLC
• Prime Vitality LLC
• Loree Ann Primeau, OTR
• Kevin Primeaux
• Primeiv Solutions LLC
• Ana Alicia Primera, CCN
• Primetrack Health LLC
• Primetrack Wellness and Rehab
• Sarah Primiano, CCC
• Maria Danielle Primm-Ballard, LPC

• Nutritionist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Nutritionist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2020; 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.