NPIMap

Organization Active NPI

Premiere Health and Wellness Medical Center

  • Internal Medicine Physician
  • Wilmington, NC
National Provider Identifier
1326404344
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9900644 Issued in NC
Legal business name
PREMIERE HEALTH AND WELLNESS MEDICAL CENTER
Practice address
1020 Rankin St
Suite 412
Wilmington, NC 28401-3700
Phone
(919) 416-4700
Fax
(919) 416-0821
NPI assigned
Jan 6, 2016
Last updated
Jan 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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

Authorized official

Name
Dr. Venus Idette Pitts, MDNPI 1740217801
Title
Owner
Phone
(919) 416-4700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9900644 NC Primary
Addiction Medicine (Internal Medicine) Physician 207RA0401X 9900644 NC
Pediatrics Physician 208000000X 9900644 NC
Obesity Medicine (Internal Medicine) Physician 207RB0002X 9900644 NC

Addresses

Primary practice location

1020 Rankin St
Suite 412
Wilmington, NC 28401-3700

Mailing address

2609 N Duke St
Suite 403
Durham, NC 27704-3048
Phone (919) 416-4700

Other identifiers 2

IdentifierTypeStateIssuer
2026035AOtherNCMEDICARE ID
89136E4MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Premiere Health and Wellness Medical Center PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2609 N Duke St
Ste 403
Durham, NC 27704
Phone (919) 220-8300

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452038400000",
    "number": "1326404344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 N DUKE ST",
            "address_2": "SUITE 403",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277043048",
            "telephone_number": "919-416-4700",
            "fax_number": "919-416-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 RANKIN ST",
            "address_2": "SUITE 412",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284013700",
            "telephone_number": "919-416-4700",
            "fax_number": "919-416-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE HEALTH AND WELLNESS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-06",
        "last_updated": "2016-01-06",
        "status": "A",
        "authorized_official_last_name": "PITTS",
        "authorized_official_first_name": "VENUS",
        "authorized_official_middle_name": "IDETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-416-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9900644",
            "primary": true
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "NC",
            "license": "9900644",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9900644",
            "primary": false
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "NC",
            "license": "9900644",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "2026035A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89136E4",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; 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.