NPIMap

Organization Active NPI

Premier Health Express and Advanced Diagnostics Inc

  • Family Medicine Physician
  • Oxon Hill, MD
National Provider Identifier
1831705748
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PREMIER HEALTH EXPRESS AND ADVANCED DIAGNOSTICS INC
Practice address
5474 Saint Barnabas Rd
Oxon Hill, MD 20745-3622
Phone
(443) 899-9525
NPI assigned
Sep 17, 2020
Organization subpart
Yes
Parent organization
PREMIER HEALTH EXPRESS AND ADVANCED DIAGNOSTICS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Authorized official

Name
Samuel Nokuri, MDNPI 1730360587
Title
MD/Owner
Phone
(443) 899-9525

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 PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

5474 Saint Barnabas Rd
Oxon Hill, MD 20745-3622

Mailing address

9710 Patuxent Woods Dr Ste 200
Columbia, MD 21046-3458
Phone (443) 899-9525

Other practice location 1

9710 Patuxent Woods Dr Ste 200
Columbia, MD 21046-3458
Phone (443) 899-9525

Other practice location 2

4821 Allentown Rd
Camp Springs, MD 20746-3933
Phone (443) 899-9525

National Provider Directory

National Provider Directory
Part of
Premier Health Express and Advanced Diagnostics Inc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620864000000",
    "number": "1831705748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9710 PATUXENT WOODS DR STE 200",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463458",
            "telephone_number": "443-899-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5474 SAINT BARNABAS RD",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453622",
            "telephone_number": "443-899-9525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9710 Patuxent Woods Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210463458",
            "country_code": "US",
            "telephone_number": "443-899-9525",
            "fax_number": "443-200-0233",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4821 Allentown Rd",
            "address_purpose": "LOCATION",
            "city": "Camp Springs",
            "state": "MD",
            "postal_code": "207463933",
            "country_code": "US",
            "telephone_number": "443-899-9525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREMIER HEALTH EXPRESS AND ADVANCED DIAGNOSTICS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER HEALTH EXPRESS AND ADVANCED DIAGNOSTICS INC",
        "enumeration_date": "2020-09-17",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A",
        "authorized_official_last_name": "NOKURI",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "443-899-9525",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxon Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; 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.