Jax Premier Health Center PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

JAX PREMIER HEALTH CENTER PLLC

Practice address

9010 R G Skinner Pkwy
Jacksonville, FL 32256-4157

Phone

(347) 469-7633

NPI assigned

Dec 5, 2024

Organization subpart

No

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

Authorized official

Name

Al Berry

Title

Manager

Phone

(469) 915-4211

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Mameyan Donzo, MD

  • Internal Medicine Physician
  • Dixon, IL
  • NPI 1548721756

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1902612898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9010 R G SKINNER PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322564157",
            "telephone_number": "347-469-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9010 R G SKINNER PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322564157",
            "telephone_number": "347-469-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAX PREMIER HEALTH CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "AL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "469-915-4211"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jax Medicalassoc.,Inc.
• Jax Mobile Urgent Care
• Jax Nora One LLC
• Jax OB-GYN PA
• Jax Patient Care
• Jax Sleep Solutions LLC
• Jax Spine & Rehab PLLC
• Jax Surgical Assist LLC
• Jax Vision Care, PA
• Jax Visiting Medical Providers LLC

• Internal Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.