Promed Preferred PA Professional Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PROMED PREFERRED PA PROFESSIONAL CORPORATION

Practice address

1003 Loop Rd
Alpine, TX 79830-3229

Phone

(615) 499-3165

NPI assigned

Nov 6, 2024

Organization subpart

No

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

Authorized official

Name

Lev Grinman, MD

Title

Owner

Phone

(615) 499-3165

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1730851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730851200000",
    "number": "1942023908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 S OYSTER BAY RD # 2059",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118033301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 LOOP RD",
            "city": "ALPINE",
            "state": "TX",
            "postal_code": "798303229",
            "telephone_number": "615-499-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMED PREFERRED PA PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-06",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A",
        "authorized_official_last_name": "GRINMAN",
        "authorized_official_first_name": "LEV",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-499-3165",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.