PMR Ky Holding, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PMR KY HOLDING, LLC

Practice address

1395 NW 167TH St
Miami Gardens, FL 33169-5742

Phone

(305) 831-4760

NPI assigned

Sep 7, 2016

Last updated

Mar 7, 2023By 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

Mary Chen

Title

Chief Operating Officer

Phone

(305) 831-4760

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Tax ID family

PMR Ky Holding LLC2 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.

• PMR Ky Holding, LLC

  • Specialist
  • Louisville, KY
  • NPI 1780950295
  NPD tax ID

Locations

Practitioners 50

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.

• Margaret Davies, NP

  • Nurse Practitioner
  • Louisville, KY
  • NPI 1265989149
  Medicare reassignment Care Compare group NPD
• Michael Gross, MD

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1568493328
  Medicare reassignment Care Compare group NPD
• Noel Prather Hawley, APRN

  • Adult Health Nurse Practitioner
  • Louisville, KY
  • NPI 1184000341
  Medicare reassignment Care Compare group NPD
• Seema Kulkarni, ARNP

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1902229305
  Medicare reassignment Care Compare group NPD
• Frank Marrero Galban, APRN

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1508518978
  Medicare reassignment Care Compare group NPD
• Anita Pierre-Antoine, MD

  • Family Medicine Physician
  • Louisville, KY
  • NPI 1578955993
  Medicare reassignment Care Compare group NPD
• Latasha Reid

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1992210165
  Medicare reassignment Care Compare group NPD
• Hershema Burnett, APRN

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1396294401
  Medicare reassignment NPD
• Aiesha N Cole, APRN

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1063979458
  Medicare reassignment NPD
• Krystal Cook, N.P.

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1881021590
  Medicare reassignment NPD
• Rickey Allen Cosby, APRN

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1730526864
  Medicare reassignment NPD
• Tyrone L Daniels, MD

  • Cardiovascular Disease Physician
  • Louisville, KY
  • NPI 1043264393
  Medicare reassignment NPD

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1740737709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695742",
            "telephone_number": "305-831-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695742",
            "telephone_number": "305-831-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PMR KY HOLDING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-07",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "305-831-4760"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• PMR la Holding, LLC (Jencare Senior Medical Center)
• PMR US Holdings, LLC
• PMR Virginia Holding, LLC (Jencare Senior Medical Centers of Virginia)
• Podiatry Associates of Miami Gardens, LLC

• Specialist in Miami Gardens, FL
• Providers in Miami Gardens, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.