Premiere Health & Wellness LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

PREMIERE HEALTH & WELLNESS LLC

Practice address

1710 1/2 Alice St
Waycross, GA 31501-5216

Phone

(912) 809-2341

Fax

(912) 809-2432

NPI assigned

Dec 5, 2022

Last updated

Jan 25, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dawn Driggers, NPNPI 1063904217

Title

Owner

Phone

(912) 614-3768

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dawn Lynn Driggers, FNP

  • Family Nurse Practitioner
  • Waycross, GA
  • NPI 1063904217
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1316658990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 1/2 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015216",
            "telephone_number": "912-809-2341",
            "fax_number": "912-809-2432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 1/2 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015216",
            "telephone_number": "912-809-2341",
            "fax_number": "912-809-2432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE HEALTH & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-05",
        "last_updated": "2023-01-25",
        "certification_date": "2022-12-21",
        "status": "A",
        "authorized_official_last_name": "DRIGGERS",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-614-3768",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003206327A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jennifer C Pritchett, D.O.
• Ruchir Puri, M.D.
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• Family Nurse Practitioner in Waycross, GA
• Providers in Waycross, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.