NPIMap

Organization Active NPI

Premise Health of New Jersey Medical, P.C.

Doing business as TLS Newark Health Center

  • Multi-Specialty Clinic/Center
  • Newark, NJ
National Provider Identifier
1396454765
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PREMISE HEALTH OF NEW JERSEY MEDICAL, P.C.
Doing business as
TLS Newark Health Center
Practice address
390 E Port St
Newark, NJ 07114-3115
Phone
(615) 468-3188
NPI assigned
Nov 15, 2022
Last updated
Nov 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Authorized official

Name
William Wright
Title
Legal Counsel
Phone
(615) 577-5893

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

390 E Port St
Newark, NJ 07114-3115

Mailing address

5500 Maryland Way Ste 120
Brentwood, TN 37027-4993

Other names 1

  • TLS Newark Health Center Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2272334Premise Health of New Jersey Medical PC390 E Port Street, Newark, NJ 07114Certificate of waiverNov 17, 2026

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of New Jersey Medical PC31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

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

View all 30

Locations

390 E Port St
Newark, NJ 07114

NPI Registry JSON

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1396454765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY STE 120",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 E PORT ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071143115",
            "telephone_number": "615-468-3188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF NEW JERSEY MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "LEGAL COUNSEL",
        "authorized_official_telephone_number": "615-577-5893"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TLS Newark Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.