Organization Active NPI

Premier Medical., LLC

Doing business as Premier Wound Care & Id Specialist

  • Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1871346940
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
PREMIER MEDICAL., LLC
Doing business as
Premier Wound Care & Id Specialist
Practice address
250 Chateau Dr SW Ste 115
Huntsville, AL 35801-3497
Phone
(256) 533-4645
Fax
(256) 808-3178
NPI assigned
Apr 9, 2024
Last updated
Jul 8, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
PREMIER MEDICALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Authorized official

Name
Summer Paige Slater, CRNPNPI 1043674252
Title
Owner
Phone
(256) 533-4645

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
Nurse Practitioner 363L00000X NU Primary

Addresses

Primary practice location

250 Chateau Dr SW Ste 115
Huntsville, AL 35801-3497

Mailing address

250 Chateau Dr SW Ste 115
Huntsville, AL 35801-3497
Phone (256) 533-4645

Other identifiers 1

IdentifierTypeStateIssuer
188348MedicaidAL

Other names 1

  • PREMIER WOUND CARE & ID SPECIALIST Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240724002169 AL Part B Supplier - Clinic/Group Practice 5597201707 Receives reassigned benefits from 2 practitioners
Practice locations: Huntsville, AL

National Provider Directory

National Provider Directory
Part of
Premier Medical LLC

Locations

250 Chateau Dr SW
Ste 115
Huntsville, AL 35801
Phone (256) 533-4645

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 2

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": "1712620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1871346940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CHATEAU DR SW STE 115",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013497",
            "telephone_number": "256-533-4645",
            "fax_number": "256-808-3178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CHATEAU DR SW STE 115",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013497",
            "telephone_number": "256-533-4645",
            "fax_number": "256-808-3178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL., LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER MEDICAL",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "SLATER",
        "authorized_official_first_name": "SUMMER",
        "authorized_official_middle_name": "PAIGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-533-4645",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188348",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PREMIER WOUND CARE & ID SPECIALIST",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.