NPIMap

Organization Active NPI

Premier Choice Primary & Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Silver Spring, MD
National Provider Identifier
1407597552
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PREMIER CHOICE PRIMARY & URGENT CARE, LLC
Practice address
12301 Old Columbia Pike Ste 100a
Silver Spring, MD 20904-1659
Phone
(301) 598-0725
Fax
(301) 598-0729
NPI assigned
Apr 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Authorized official

Name
Clara Evans
Title
Provider
Phone
(240) 855-4923

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

12301 Old Columbia Pike Ste 100a
Silver Spring, MD 20904-1659

Mailing address

12301 Old Columbia Pike Ste 100a
Silver Spring, MD 20904-1659
Phone (301) 598-0725

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220525001532 DC Part B Supplier - Clinic/Group Practice 8325426729 Receives reassigned benefits from 3 practitioners
Practice locations: Silver Spring, MD

National Provider Directory

National Provider Directory

Locations

13975 Connecticut Ave
Ste 250
Silver Spring, MD 20906
Phone (240) 730-4455

Practitioners & affiliated clinicians

Practitioners 3

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": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1407597552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 OLD COLUMBIA PIKE STE 100A",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041659",
            "telephone_number": "301-598-0725",
            "fax_number": "301-598-0729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 OLD COLUMBIA PIKE STE 100A",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041659",
            "telephone_number": "301-598-0725",
            "fax_number": "301-598-0729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CHOICE PRIMARY & URGENT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-05",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "CLARA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "240-855-4923"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.