Premier Medical Center, Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

21076 Issued in SC

Legal business name

PREMIER MEDICAL CENTER, INC

Practice address

5390 Dorchester Rd
North Charleston, SC 29418-5652

Phone

(843) 552-3099

Fax

(843) 552-3277

NPI assigned

Jul 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Eni Clement Okonofua, M.B.,B.SNPI 1295770436

Title

President

Phone

(843) 568-8330

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eni Clement Okonofua, M.B.,B.S.

  • Internal Medicine Physician
  • North Charleston, SC
  • NPI 1295770436
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1699704569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31292",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294171292",
            "telephone_number": "843-552-3099",
            "fax_number": "843-559-9037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5390 DORCHESTER RD",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294185652",
            "telephone_number": "843-552-3099",
            "fax_number": "843-552-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "OKONOFUA",
        "authorized_official_first_name": "ENI",
        "authorized_official_middle_name": "CLEMENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-568-8330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.B.,B.S"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "SC",
            "license": "21076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T53518",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Haley Powers
• Cameron Joshua Poyner, MS, BA
• PPCP Specialty Physicians , LLC
• John M Pratt, MD
• Premier Internal Medicine, LLC
• Premier Medical of SC LLC (Premier Medical)
• Premiere Mobile Compliance LLC
• Pamela Presley Jones, LPC
• Kyle James Pressler, DO
• Eric Thomas Pride, M.D.

• Primary Care Clinic/Center in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Primary Care Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.