Premium Wellness and Primary Care

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

PREMIUM WELLNESS AND PRIMARY CARE

Practice address

308 Pomona Dr Ste a
Greensboro, NC 27407-1644

Phone

(336) 553-0793

NPI assigned

Jun 18, 2016

Last updated

Jul 12, 2024By 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

Monica Dianne Zellous

Title

Practice Manager

Phone

(336) 553-0793

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21909/brand/1/csg/1/fhir/r4

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.

• Takela Naquay Anderson, FNP

  • Family Nurse Practitioner
  • Greensboro, NC
  • NPI 1023342144
  Medicare reassignment NPD

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

{
    "created_epoch": "1466208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1336599547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 POMONA DR STE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274071644",
            "telephone_number": "336-553-0793",
            "fax_number": "336-553-0795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 POMONA DR STE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274071644",
            "telephone_number": "336-553-0793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM WELLNESS AND PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-18",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "ZELLOUS",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "DIANNE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "336-553-0793"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NC",
            "license": "5004483",
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NC",
            "license": "5006433",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8975633",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Precious Medical Transport, Inc
• Precious Pearl Group Home, Inc.
• Preferred Home and Hospice Care and Opt PLLC
• Premise Health of North Carolina Medical PC (Truist Greensboro)
• Premise Health of North Carolina Medical PC (TBMNC Occupational Health & First Aid)
• Presbyterian Counseling Center of Greensboro, Inc
• Presbyterian Homes Inc (Presbyterian Home of High Point)
• Alexandra Jane Prescott
• Katherine Ann Prescott, ATC, LAT
• Alison Brook Presley

• Primary Care Nurse Practitioner in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Primary Care Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.