Primetime Chronic Care Management, LLC

Primary specialty

Prevention ProfessionalTaxonomy code 405300000X

Legal business name

PRIMETIME CHRONIC CARE MANAGEMENT, LLC

Practice address

117 Autumn Creek Dr
Madisonville, LA 70447-3603

Phone

(901) 626-2129

NPI assigned

Jan 23, 2017

Organization subpart

No

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

Authorized official

Name

Atnena Luster, NP

Title

Managing Provider

Phone

(901) 288-5200

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485129600000",
    "number": "1821535360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 CHURCH STREET",
            "city": "GREENSBURG",
            "state": "LA",
            "postal_code": "70441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 AUTUMN CREEK DR",
            "city": "MADISONVILLE",
            "state": "LA",
            "postal_code": "704473603",
            "telephone_number": "901-626-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMETIME CHRONIC CARE MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-23",
        "last_updated": "2017-01-23",
        "status": "A",
        "authorized_official_last_name": "LUSTER",
        "authorized_official_first_name": "ATNENA",
        "authorized_official_title_or_position": "MANAGING PROVIDER",
        "authorized_official_telephone_number": "901-288-5200",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Prevention Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prevention Professional in Madisonville, LA
• Providers in Madisonville, LA by specialty
• Prevention Professional in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.