NPIMap

Organization Active NPI

Premier Mobile Medical Clinic PLLC

  • Clinic/Center
  • Fort Myers, FL
National Provider Identifier
1386327872
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PREMIER MOBILE MEDICAL CLINIC PLLC
Practice address
10676 Colonial Blvd Ste 20
Fort Myers, FL 33913-8715
Phone
(239) 288-7949
Fax
(239) 208-3944
NPI assigned
Aug 10, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Authorized official

Name
Nadine-Anne Orinthea Singh, APRN
Title
Owner
Phone
(239) 288-7949

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Adult Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2200X

Addresses

Primary practice location

10676 Colonial Blvd Ste 20
Fort Myers, FL 33913-8715

Mailing address

10676 Colonial Blvd Ste 20
Fort Myers, FL 33913-8715
Phone (239) 288-7949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231205001429 FL Part B Supplier - Clinic/Group Practice 7012365893 Receives reassigned benefits from 3 practitioners
Practice locations: Fort Myers, FL

National Provider Directory

National Provider Directory

Locations

10676 Colonial Blvd
Fort Myers, FL 33913

Practitioners & affiliated clinicians

Practitioners 7

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": "1691625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691625600000",
    "number": "1386327872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10676 COLONIAL BLVD STE 20",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138715",
            "telephone_number": "239-288-7949",
            "fax_number": "239-208-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10676 COLONIAL BLVD STE 20",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138715",
            "telephone_number": "239-288-7949",
            "fax_number": "239-208-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MOBILE MEDICAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A",
        "authorized_official_last_name": "SINGH",
        "authorized_official_first_name": "NADINE-ANNE",
        "authorized_official_middle_name": "ORINTHEA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-288-7949",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.