Premium Family Health Care, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MA071041 Issued in NJ

Legal business name

PREMIUM FAMILY HEALTH CARE, LLC

Practice address

115 Christopher Columbus Dr
Suite 300
Jersey City, NJ 07302-5526

Phone

(201) 547-3555

Fax

(201) 547-8259

NPI assigned

Feb 9, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Carol Christine Skipper, MD

Title

Medical Director

Phone

(201) 547-3555

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1265673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265673600000",
    "number": "1407188923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 CHRISTOPHER COLUMBUS DR",
            "address_2": "SUITE 300",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073025526",
            "telephone_number": "201-547-3555",
            "fax_number": "201-547-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 CHRISTOPHER COLUMBUS DR",
            "address_2": "SUITE 300",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073025526",
            "telephone_number": "201-547-3555",
            "fax_number": "201-547-8259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM FAMILY HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-09",
        "last_updated": "2010-02-09",
        "status": "A",
        "authorized_official_last_name": "SKIPPER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "CHRISTINE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "201-547-3555",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA071041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premise Health of New Jersey Medical PC
• Premise Health of New Jersey Medical PC
• Premise Health of New Jersey Medical, P.C
• Premise Health of New Jersey Medical, P.C
• Premium Care Physical Therapy LLC
• Fred Prendergass, CRNA
• Kimlin Prendergass, NP-C
• Prescription Shoppe LLC
• Prescription Shoppe LLC
• James Prete, D.C.

• Family Medicine Physician in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.