NPIMap

Organization Active NPI

Premium Urgent Care, Inc

Doing business as Premium Urgent Care

  • Urgent Care Clinic/Center
  • Clovis, CA
National Provider Identifier
1851764492
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PREMIUM URGENT CARE, INC
Doing business as
Premium Urgent Care
Practice address
2021 Herndon Ave
Suite 101
Clovis, CA 93611-6101
Phone
(559) 797-4315
Fax
(559) 321-8730
NPI assigned
Nov 4, 2015
Last updated
Nov 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Authorized official

Name
Dr. Erick J Green, MDNPI 1821371022
Title
Owner
Phone
(559) 797-4315

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

2021 Herndon Ave
Suite 101
Clovis, CA 93611-6101

Mailing address

2021 Herndon Ave
Suite 101
Clovis, CA 93611-6101
Phone (559) 797-4315

Other identifiers 1

IdentifierTypeStateIssuer
109622OtherCAPREMIUM URGENT CARE GRP PTAN

Other names 1

  • PREMIUM URGENT CARE Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446595200000",
    "number": "1851764492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 HERNDON AVE",
            "address_2": "SUITE 101",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116101",
            "telephone_number": "559-797-4315",
            "fax_number": "559-321-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 HERNDON AVE",
            "address_2": "SUITE 101",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116101",
            "telephone_number": "559-797-4315",
            "fax_number": "559-321-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM URGENT CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-04",
        "last_updated": "2015-11-04",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "ERICK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "559-797-4315",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMIUM URGENT CARE GRP PTAN",
            "identifier": "109622",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PREMIUM URGENT CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clovis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.