NPIMap

Organization Active NPI

Premier Immediate Care of Georgia, PC

  • Primary Care Clinic/Center
  • Lawrenceville, GA
National Provider Identifier
1356472914
Registry record updated Sep 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
047601 Issued in GA
Legal business name
PREMIER IMMEDIATE CARE OF GEORGIA, PC
Doing business as
Premier Immediate Care
Practice address
289 Grayson Hwy
Lawrenceville, GA 30046-5726
Phone
(678) 376-1300
Fax
(678) 407-1469
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2010

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

Authorized official

Name
Philip Norton Henderson, MD, MPH, MBA
Title
President
Phone
(678) 376-1300

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 047601 GA Primary
Urgent Care Clinic/Center 261QU0200X 047601 GA
Occupational Medicine Clinic/Center 261QX0100X 047601 GA

Addresses

Primary practice location

289 Grayson Hwy
Lawrenceville, GA 30046-5726

Mailing address

PO Box 8581
Belfast, ME 04915-8581
Phone (678) 376-1300

Other names 1

  • Premier Immediate Care Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285286400000",
    "number": "1356472914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8581",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049158581",
            "telephone_number": "678-376-1300",
            "fax_number": "678-407-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 GRAYSON HWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300465726",
            "telephone_number": "678-376-1300",
            "fax_number": "678-407-1469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER IMMEDIATE CARE OF GEORGIA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2010-09-24",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "NORTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-376-1300",
        "authorized_official_credential": "MD, MPH, MBA"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "047601",
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "GA",
            "license": "047601",
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "GA",
            "license": "047601",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Immediate Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2010; 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.