Premier Care Medical

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

PREMIER CARE MEDICAL

Practice address

3609 Outdoor Sportsman PL Ste 7
Kodak, TN 37764-1477

Phone

(865) 210-3452

NPI assigned

Dec 10, 2019

Organization subpart

No

Name

Mr. Ian P Clarke

Title

Owner

Phone

(865) 281-5922

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 10, 2019.

{
    "created_epoch": "1575936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575936000000",
    "number": "1164069084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3609 OUTDOOR SPORTSMAN PL STE 7",
            "city": "KODAK",
            "state": "TN",
            "postal_code": "377641477",
            "telephone_number": "865-210-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3609 OUTDOOR SPORTSMAN PL STE 7",
            "city": "KODAK",
            "state": "TN",
            "postal_code": "377641477",
            "telephone_number": "865-210-3452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CARE MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-10",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "IAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "865-281-5922",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Kodak, TN
• Urgent Care Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; 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.