Premier Assisted Living Facility, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PREMIER ASSISTED LIVING FACILITY, LLC

Practice address

319 Eldridge Ave
Orange Park, FL 32073-2956

Phone

(904) 541-4605

Fax

(904) 644-8378

NPI assigned

May 26, 2022

Last updated

May 26, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ashraf Gayed Andrawis, MDNPI 1568445666

Title

Owner

Phone

(904) 451-5570

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

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.

• Ashraf Gayed Andrawis, MD

  • Pain Medicine Physician
  • Orange Park, FL
  • NPI 1568445666
  NPD Authorized official

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653523200000",
    "number": "1962140210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 PASSAGE DR",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320038077",
            "telephone_number": "904-451-5570",
            "fax_number": "904-644-8378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 ELDRIDGE AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320732956",
            "telephone_number": "904-541-4605",
            "fax_number": "904-644-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ASSISTED LIVING FACILITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "ANDRAWIS",
        "authorized_official_first_name": "ASHRAF",
        "authorized_official_middle_name": "GAYED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-451-5570",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Powers, COTA/L
• Robert Roland Powers, D.O.
• Michelle Pozek
• Tamika Nicole Pratt
• Shyamaly Premaraj, DDS
• Premier Spine & Pain Center PA
• Anthony Robert Preta, P.T.A.
• Jalana Aareon Prevatt
• Johann Nicholas Prewett, PH.D.
• Jacqueline Elette Price, CRNA

• Assisted Living Facility in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.