NPIMap

Organization Active NPI

Premier Community Healthcare Group Inc

  • Federally Qualified Health Center (FQHC)
  • Zephyrhills, FL
National Provider Identifier
1316919491
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PREMIER COMMUNITY HEALTHCARE GROUP INC
Practice address
37840 Medical Arts CT
Zephyrhills, FL 33541-4325
Phone
(352) 518-2000
Fax
(352) 567-5455
NPI assigned
Feb 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Authorized official

Name
Joseph Resnick
Title
Ceo
Phone
(352) 518-2000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

37840 Medical Arts CT
Zephyrhills, FL 33541-4325

Mailing address

PO Box 232
Dade City, FL 33526-0232
Phone (352) 518-2000

Other identifiers 1

IdentifierTypeStateIssuer
029550702MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110225000334 FL Part A Provider - Federally Qualified Health Center (FQHC) 3476450818 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Zephyrhills, FL
O20190513000272 FL Part A Provider - Federally Qualified Health Center (FQHC) 3476450818 Practice locations: Zephyrhills, FL

Federally qualified health center certification: CCN 101064

Legal name
PREMIER COMMUNITY HEALTH CARE GROUP INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 19, 2011
Last certification
Jan 19, 2011
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 29, 1979 in FL
Enrollment address
38030 Daughtery Rd
Zephyrhills, FL 33540-1375

Federally qualified health center certification: CCN 681144

Legal name
PREMIER COMMUNITY HEALTH CARE GROUP INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 13, 2019
Last certification
May 13, 2019
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jul 29, 1979 in FL
Enrollment address
37840 Medical Arts CT
Zephyrhills, FL 33541-4325

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Joseph Resnick Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2014 100%
Corporate OfficerCeo Sep 1, 2014 100%
W-2 Managing EmployeeCeo Sep 1, 2014 100%
Corporate OfficerCeo Apr 1, 2019 100%
W-2 Managing EmployeeCeo Apr 1, 2019 100%
Premier Community Health Care Group Inc Organization, Dade City, FL Corporation Operational/Managerial Control Apr 1, 2019 100%

Owners & managing parties with NPI records 9

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Premier Community Health Care Group IncNew Port Richey, FL, CCN 101042 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 6

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": "1138924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1316919491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335260232",
            "telephone_number": "352-518-2000",
            "fax_number": "352-567-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37840 MEDICAL ARTS CT",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335414325",
            "telephone_number": "352-518-2000",
            "fax_number": "352-567-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER COMMUNITY HEALTHCARE GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-03",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A",
        "authorized_official_last_name": "RESNICK",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "352-518-2000"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029550702",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

Verify at the official NPI Registry.