NPIMap

Organization Active NPI

Premium Urgent Care, Inc.

Doing business as Premium Urgent Care

  • Urgent Care Clinic/Center
  • Fresno, CA
National Provider Identifier
1942696455
Registry record updated May 2, 2019
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
505 N Clovis Ave
Fresno, CA 93727-2617
Phone
(559) 412-8847
Fax
(559) 412-8447
NPI assigned
Apr 10, 2015
Last updated
May 2, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2019

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

Authorized official

Name
Dr. Erick J Green, M.D.NPI 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

505 N Clovis Ave
Fresno, CA 93727-2617

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
CA109622OtherCAPREMIUM URGENT CARE GRP PTAN

Other names 1

  • Premium Urgent Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131223000834 CA Part B Supplier - Clinic/Group Practice 9638306533 Receives reassigned benefits from 11 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clovis, CA; Fresno, CA; Los Banos, CA; Selma, CA

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2107196Premium Urgent Care Inc505 N Clovis Ave Ste B, Fresno, CA 93727Certificate of waiverSep 10, 2026

National Provider Directory

National Provider Directory

Locations

3000 Floral Ave
Selma, CA 93662
Phone (559) 318-9240

Practitioners & affiliated clinicians

Practitioners 4

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": "1428624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556755200000",
    "number": "1942696455",
    "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": "505 N CLOVIS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937272617",
            "telephone_number": "559-412-8847",
            "fax_number": "559-412-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM URGENT CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-10",
        "last_updated": "2019-05-02",
        "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": "M.D."
    },
    "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": "CA109622",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premium Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premium Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.