Premiercare Medical Clinic

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

PREMIERCARE MEDICAL CLINIC

Practice address

6500 Northwest Dr Ste 350
Mesquite, TX 75150-1364

Phone

(972) 373-4191

Fax

(972) 373-4569

NPI assigned

Aug 30, 2019

Organization subpart

No

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

Authorized official

Name

Ekeoma I. Cooper, D-NURSE PRACTITIONERNPI 1578029534

Title

DNP

Phone

(972) 373-4191

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ekeoma I Cooper

  • Gerontology Nurse Practitioner
  • Mesquite, TX
  • NPI 1578029534

  Multi-Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1346898418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 NORTHWEST DR STE 350",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751501364",
            "telephone_number": "972-373-4191",
            "fax_number": "972-373-4569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 NORTHWEST DR STE 350",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751501364",
            "telephone_number": "972-373-4191",
            "fax_number": "972-373-4569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERCARE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-30",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "EKEOMA",
        "authorized_official_middle_name": "I.",
        "authorized_official_title_or_position": "DNP",
        "authorized_official_telephone_number": "972-373-4191",
        "authorized_official_credential": "D-NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408711601",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "getpremiercare@gmail.com",
            "affiliation": "N",
            "endpointDescription": "PremierCare Medical Clinic",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "mails",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PremierCare Medical Clinic",
            "address_1": "6500 Northwest Dr Ste 350",
            "city": "Mesquite",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751501364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Prestige Phlebotomy, Corporation
• Louise Preston, LPC

• Nurse Practitioner in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.