Premier Medical Care LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PREMIER MEDICAL CARE LLC

Practice address

340 Broad St
Suite 100
Windsor, CT 06095-3030

Phone

(860) 587-7170

Fax

(860) 580-7177

NPI assigned

Sep 10, 2014

Last updated

Sep 10, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mohammed A Memon, MD

Title

Director

Phone

(860) 587-7170

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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.

• Johnny C Wright, M.D., D.P.M.

  • Family Medicine Physician
  • Windsor, CT
  • NPI 1952455370
  Medicare reassignment

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

{
    "created_epoch": "1410307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410307200000",
    "number": "1679974521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 BROAD ST",
            "address_2": "SUITE 100",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060953030",
            "telephone_number": "860-587-7170",
            "fax_number": "860-580-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 BROAD ST",
            "address_2": "SUITE 100",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060953030",
            "telephone_number": "860-587-7170",
            "fax_number": "860-580-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-10",
        "last_updated": "2014-09-10",
        "status": "A",
        "authorized_official_last_name": "MEMON",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "860-587-7170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001425885",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shanae Porter
• Abigail Grace Potash
• Troy David Poynton Jr.
• Lindsay Pratt-Bluemle, LCSW
• Heather Pratt
• Premier Pediatrics of Connecticut
• Premier Provider Services
• Price Chopper Inc (Price Chopper Pharmacy)
• Calvin S Price, O.D.
• Kelli Price, LPC

• Internal Medicine Physician in Windsor, CT
• Providers in Windsor, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.