Prestige Urgent Care Center

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

PRESTIGE URGENT CARE CENTER

Practice address

570 Clark Dr
Ellenwood, GA 30294-2660

Phone

(844) 377-3784

NPI assigned

Dec 23, 2015

Last updated

Dec 23, 2015By 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

Veronica Cervantes

Title

Ceo

Phone

(844) 377-3784

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450828800000",
    "number": "1811352487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 CLARK DR",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302942660",
            "telephone_number": "844-377-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 CLARK DR",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302942660",
            "telephone_number": "844-377-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE URGENT CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-23",
        "last_updated": "2015-12-23",
        "status": "A",
        "authorized_official_last_name": "CERVANTES",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "844-377-3784"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Ellenwood, GA
• Providers in Ellenwood, GA by specialty
• Multi-Specialty Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.