NPIMap

Organization Active NPI

Premier Primary Care, PLLC

Doing business as Premier Primary Care

  • Rural Health Clinic/Center
  • Union City, TN
National Provider Identifier
1629843685
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PREMIER PRIMARY CARE, PLLC
Doing business as
Premier Primary Care
Practice address
702 Sherrill St Ste B
Union City, TN 38261-5891
Phone
(731) 885-8884
NPI assigned
Nov 20, 2023
Last updated
Nov 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Authorized official

Name
Tina M Wright
Title
Practice Manager
Phone
(731) 885-8884

Specialties & licenses 1

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

Addresses

Primary practice location

702 Sherrill St Ste B
Union City, TN 38261-5891

Mailing address

702 Sherrill St
Union City, TN 38261-5891
Phone (731) 885-8884

Other names 1

  • Premier Primary Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231215000318 TN Part A Provider - Rural Health Clinic 3870816721 Practice locations: Union City, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629843685. Details of each certification follow.

Rural health clinic certification: CCN 883967

Legal name
PREMIER PRIMARY CARE, PLLC
Doing business as
PREMIER PRIMARY CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 23, 2024
Last certification
May 23, 2024
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Feb 1, 2014 in TN
Enrollment address
702 Sherrill St
Ste B
Union City, TN 38261-5891

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
Tax ID family
Premier Primary Care3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

702 Sherrill St
Union City, TN 38261
Phone (731) 885-8884

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JCCDCD

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Tina Wright Individual Contracted Managing Employee Feb 1, 2014
Operational/Managerial Control Feb 1, 2014
Premier Medical Management LLC Organization, Union City, TN LLC Operational/Managerial Control Feb 1, 2014
Brenda R. Dexter Individual 5% Or Greater Direct Ownership InterestDNP Feb 1, 2014 95%
James T Batey Individual 5% Or Greater Direct Ownership InterestMD Feb 1, 2014 5%

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1629843685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SHERRILL ST",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615891",
            "telephone_number": "731-885-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 SHERRILL ST STE B",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615891",
            "telephone_number": "731-885-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PRIMARY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-20",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "731-885-8884"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Union City, TN

Sources for this page

Verify at the official NPI Registry.