Premier Urgent Care of Brevard LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

PREMIER URGENT CARE OF BREVARD LLC

Doing business as

Premier Urgent Care at Suntree/Premier Urgent Care at Viera

Practice address

6300 N Wickham Rd
Suite 108
Melbourne, FL 32940-2028

Phone

(321) 253-2169

Fax

(321) 253-1720

NPI assigned

Oct 26, 2006

Last updated

Oct 22, 2007By 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

Dr. Stephen K Badolato, MDNPI 1194728832

Title

Physician/Owner

Phone

(321) 253-2169

Specialties & licenses 1

Addresses

Other names 1

• Premier Urgent Care at Suntree/Premier Urgent Care at Viera Doing business as

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

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners 3

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.

• Stephen K Badolato, MD

  • Sports Medicine (Family Medicine) Physician
  • Melbourne, FL
  • NPI 1194728832
  Authorized official Same address or phone
• Yvette Marie Lopez-Granberry, M.D.

  • Internal Medicine Physician
  • Melbourne, FL
  • NPI 1750384772
  NPD (past)
• Brad Nelson, DC

  • Chiropractor
  • Melbourne, FL
  • NPI 1770871659
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1396820742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 N WICKHAM RD",
            "address_2": "SUITE 108",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402028",
            "telephone_number": "321-253-2169",
            "fax_number": "321-253-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 N WICKHAM RD",
            "address_2": "SUITE 108",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402028",
            "telephone_number": "321-253-2169",
            "fax_number": "321-253-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER URGENT CARE OF BREVARD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "BADOLATO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "321-253-2169",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Urgent Care at Suntree/Premier Urgent Care at Viera",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hailey Rose Prechtel, RBT
• Prefix Suffix LLC (Heart of a Servant Service)
• Cherryl Ann Premdass, M.D.
• Premier Orthotics & Prosthetics, LLC
• Premier Physical Therapy & Sports Medicine
• Premiere Medical Group PA
• Brendan Michael Prendergast, M.D.
• Christopher Thomas Prendergast, R.PH
• Lindsay Jane Prendergast
• Rachel Prendergast, LCSW

• Urgent Care Clinic/Center in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Urgent Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; 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.