NPIMap

Organization Active NPI

Premier Family Care, LLC

  • Family Medicine Physician
  • Guntersville, AL
National Provider Identifier
1831493675
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PREMIER FAMILY CARE, LLC
Practice address
2017 Obrig Ave
Guntersville, AL 35976-2156
Phone
(256) 582-2324
Fax
(256) 582-2321
NPI assigned
Jan 10, 2011
Last updated
Jan 10, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

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

Authorized official

Name
Jess H Youngblood, M.D.NPI 1467676676
Title
Owner
Phone
(256) 582-2324

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

2017 Obrig Ave
Guntersville, AL 35976-2156

Mailing address

2017 Obrig Ave
Guntersville, AL 35976-2156
Phone (256) 582-2324

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110218000312 AL Part B Supplier - Clinic/Group Practice 5597959767 Receives reassigned benefits from 13 practitioners
Practice locations: Guntersville, AL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Premier Family Care2 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.

Locations

1407 Blount Ave
Guntersville, AL 35976
Phone (256) 582-2324

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294617600000",
    "number": "1831493675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 OBRIG AVE",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359762156",
            "telephone_number": "256-582-2324",
            "fax_number": "256-582-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 OBRIG AVE",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359762156",
            "telephone_number": "256-582-2324",
            "fax_number": "256-582-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER FAMILY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-10",
        "last_updated": "2011-01-10",
        "status": "A",
        "authorized_official_last_name": "YOUNGBLOOD",
        "authorized_official_first_name": "JESS",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-582-2324",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guntersville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; 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.