NPIMap

Organization Active NPI

Premier Physician Holdings, LLC

  • Urgent Care Clinic/Center
  • Wellington, FL
National Provider Identifier
1831838010
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PREMIER PHYSICIAN HOLDINGS, LLC
Practice address
1037 S State Road 7 Ste 113114
Wellington, FL 33414-6138
Phone
(561) 798-3030
NPI assigned
Jun 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Authorized official

Name
Penelope Kokkinides
Title
Chief Administrative Officer
Phone
(201) 969-2404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1037 S State Road 7 Ste 113114
Wellington, FL 33414-6138

Mailing address

6900 Tavistock Lakes Blvd Ste 300
Orlando, FL 32827-7592
Phone (321) 332-6947

Other names 1

  • Premier Urgent Care Doing business as

National Provider Directory

National Provider Directory

Locations

1037 S State Road 7
Ste 113114
Wellington, FL 33414

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654214400000",
    "number": "1831838010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 TAVISTOCK LAKES BLVD STE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277592",
            "telephone_number": "321-332-6947",
            "fax_number": "407-286-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 S STATE ROAD 7 STE 113114",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146138",
            "telephone_number": "561-798-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PHYSICIAN HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A",
        "authorized_official_last_name": "KOKKINIDES",
        "authorized_official_first_name": "PENELOPE",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "201-969-2404"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; 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.