Premier Gynecology & Wellness, PLLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

2008-00351 Issued in NC

Legal business name

PREMIER GYNECOLOGY & WELLNESS, PLLC

Practice address

2310 Randolph Rd Ste B
Charlotte, NC 28207-1526

Phone

(704) 650-7156

Fax

(855) 695-6439

NPI assigned

May 18, 2018

Last updated

Jun 11, 2019By 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. Elizabeth Box Moran, MDNPI 1659400729

Title

Owner

Phone

(704) 650-7156

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 5

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.

• Elizabeth Box Moran, MD

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
  • NPI 1659400729
  Medicare reassignment Care Compare group NPD Authorized official
• Jasmine T Cutlip, APRN,FNP-C

  • Nurse Practitioner
  • Huntersville, NC
  • NPI 1629553532
  Medicare reassignment Care Compare group NPD
• Heather Graham, M.D.

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
  • NPI 1104089952
  Medicare reassignment Care Compare group NPD
• Whitney Simmons Hoag, WHNP

  • Women's Health Nurse Practitioner
  • Charlotte, NC
  • NPI 1437942802
  Medicare reassignment Care Compare group NPD
• Jackie Alan Lucas, MD

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
  • NPI 1003846064
  Medicare reassignment NPD

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

{
    "created_epoch": "1526601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1720578313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 RANDOLPH RD STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 RANDOLPH RD STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071526",
            "telephone_number": "704-650-7156",
            "fax_number": "855-695-6439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER GYNECOLOGY & WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-18",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "BOX",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-650-7156",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NC",
            "license": "2008-00351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premcare
• Premier Analytical Services
• Premier Cardiovascular Care & Wellness (Premier Cardiovascular Care, LLC)
• Premier Clinics
• Premier Community Associates, Inc.
• Premier Healthcare Staffing, LLC
• Premier Home Health Care Services, Inc.
• Premier Home Health Care Services, Inc.
• Premier Imaging Group, P.a.
• Premier Nursing Staffing Agency LLC

• Medical Specialty Clinic/Center in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Medical Specialty Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.