Organization Active NPI

Premier Medical Associates

  • Family Medicine Physician
  • Mt Sterling, KY
National Provider Identifier
1801498720
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PREMIER MEDICAL ASSOCIATES
Practice address
805 Alexa Dr Ste C
Mt Sterling, KY 40353-1000
Phone
(859) 499-3900
NPI assigned
Nov 16, 2020
Last updated
Apr 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Authorized official

Name
Brandy Bromagen Fouch, MDNPI 1417967753
Title
Owner
Phone
(859) 498-5243

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

805 Alexa Dr Ste C
Mt Sterling, KY 40353-1000

Mailing address

805 Alexa Dr Ste C
Mt Sterling, KY 40353-1000
Phone (859) 499-3900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210107001728 KY Part B Supplier - Clinic/Group Practice 9133532344 Receives reassigned benefits from 3 practitioners
Practice locations: Mt Sterling, KY

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2200094Premier Medical Associates, PLLC805 Alexa Drive Suite C, Mount Sterling, KY 40353Certificate of waiverJan 15, 2028

National Provider Directory

National Provider Directory

Locations

805 Alexa Dr
Ste C
Mt Sterling, KY 40353
Phone (859) 499-3900

Practitioners & affiliated clinicians

Practitioners 4

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": "1605484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649808000000",
    "number": "1801498720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 ALEXA DR STE C",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403531000",
            "telephone_number": "859-499-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 ALEXA DR STE C",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403531000",
            "telephone_number": "859-499-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-16",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A",
        "authorized_official_last_name": "FOUCH",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_middle_name": "BROMAGEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-498-5243",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Sterling, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; 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.