NPIMap

Organization Active NPI

Premier Family Care, LLC

  • Rural Health Clinic/Center
  • Guntersville, AL
National Provider Identifier
1487968525
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
27882 Issued in AL
Legal business name
PREMIER FAMILY CARE, LLC
Practice address
2017 Obrig Ave
Guntersville, AL 35976-2156
Phone
(256) 486-7088
NPI assigned
Jul 30, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

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

Authorized official

Name
Dr. Jess H Youngblood, M.D.NPI 1467676676
Title
President
Phone
(256) 582-2324

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 27882 AL Primary

Addresses

Primary practice location

2017 Obrig Ave
Guntersville, AL 35976-2156

Mailing address

2017 Obrig Ave
Guntersville, AL 35976-2156
Phone (256) 582-2324

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101101001575 AL Part A Provider - Rural Health Clinic 5597959767 Practice locations: Guntersville, AL

Rural health clinic certification: CCN 013957

Legal name
PREMIER FAMILY CARE, LLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 24, 2011
Last certification
Feb 18, 2025
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
May 14, 2010 in AL
Enrollment address
1407 Blount Ave
Guntersville, AL 35976-1888

Other NPIs with the same Medicare PAC ID 1

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

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
01D2012055Premier Family Care LLC1407 Blount Avenue, Guntersville, AL 35976Provider-performed microscopyAug 26, 2026

National Provider Directory

National Provider Directory
Tax ID family
Premier Family Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1407 Blount Ave
Guntersville, AL 35976
Phone (256) 582-2324

14224 US Highway 431
Guntersville, AL 35976
Phone (256) 582-3020

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Cheyenne Crowe Individual Contracted Managing EmployeeBilling Specialist / Consultant Sep 1, 2023
Lisa Heard Individual W-2 Managing EmployeeOffice Manager Apr 20, 2021
Jess H Youngblood Individual 5% Or Greater Direct Ownership Interest Nov 1, 2010 100%
W-2 Managing EmployeePresident Nov 1, 2010 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 6

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": "1280448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294617600000",
    "number": "1487968525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 OBRIG AVE",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359762156",
            "telephone_number": "256-582-2324",
            "fax_number": "256-582-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 OBRIG AVE",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359762156",
            "telephone_number": "256-486-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER FAMILY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-30",
        "last_updated": "2011-01-10",
        "status": "A",
        "authorized_official_last_name": "YOUNGBLOOD",
        "authorized_official_first_name": "JESS",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-582-2324",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "AL",
            "license": "27882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guntersville, AL

Sources for this page

Verify at the official NPI Registry.