NPIMap

Organization Active NPI

Premier Medical Associates of Florida LLC

Doing business as Pioneer Clinical Labs

  • Clinical Laboratory Director (Non-physician)
  • Ocala, FL
National Provider Identifier
1417475872
Registry record updated Jul 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X
Legal business name
PREMIER MEDICAL ASSOCIATES OF FLORIDA LLC
Doing business as
Pioneer Clinical Labs
Practice address
9311 SW Highway 200 # A2
Ocala, FL 34481-9657
Phone
(352) 362-0627
Fax
(877) 573-9013
NPI assigned
Sep 6, 2017
Last updated
Jul 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2024

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

Authorized official

Name
Edward R Kop
Title
Lab Manager
Phone
(352) 362-0627

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Laboratory Technician 246RM2200X
Clinical Laboratory Director (Non-physician) 247ZC0005X Primary

Addresses

Primary practice location

9311 SW Highway 200 # A2
Ocala, FL 34481-9657

Mailing address

9311 SW Highway 200 # A2
Ocala, FL 34481-9657
Phone (352) 362-0627

Other names 1

  • Pioneer Clinical Labs Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Ecw Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220512000479 FL Part B Supplier - Independent Clinical Laboratory 1557773413 Practice locations: Ocala, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

4901 E Silver Springs Blvd
Ste 704
Ocala, FL 34470

9311 SW Highway 200
#A2
Ocala, FL 34481
Phone (352) 362-0627

9311 SW Highway 200
Unit A2
Ocala, FL 34481
Phone (352) 362-0627

430 W Gulf Atlantic Hwy
Wildwood, FL 34785

Practitioners & affiliated clinicians

Practitioners 72

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.

View all 72

NPI Registry JSON

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

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721520000000",
    "number": "1417475872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9311 SW HIGHWAY 200 # A2",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344819657",
            "telephone_number": "352-362-0627",
            "fax_number": "877-573-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9311 SW HIGHWAY 200 # A2",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344819657",
            "telephone_number": "352-362-0627",
            "fax_number": "877-573-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL ASSOCIATES OF FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-06",
        "last_updated": "2024-07-21",
        "certification_date": "2024-07-21",
        "status": "A",
        "authorized_official_last_name": "KOP",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "LAB MANAGER",
        "authorized_official_telephone_number": "352-362-0627"
    },
    "taxonomies": [
        {
            "code": "246RM2200X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ecw",
            "affiliation": "N",
            "endpointDescription": "EMR SYSTEM",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9311 SW Highway 200 # A2",
            "city": "Ocala",
            "state": "FL",
            "country_code": "US",
            "postal_code": "344819657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Pioneer Clinical Labs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.