PREMIUM WELLNESS AND PRIMARY CARE (NPI# 1336599547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1336599547 |
Entity Type | Organization |
Organization Name | PREMIUM WELLNESS AND PRIMARY CARE |
Practice Address |
4002 Spring Garden St Suite C Greensboro NC 27407-1683 |
Practice Telephone | 3365530793 |
Mailing Telephone | 3365530793 |
Enumeration Date | 2016-06-18 |
Last Update Date | 2016-12-01 |
Authorized Official Name | MR. BYRON GLADDEN (CREDENTIAL SPECIALIST) |
Authorized Official Telephone | 3365530793 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QH0100X |
Clinic/Center Specialization: Health Service |
5006433 | NC | Ambulatory Health Care Facilities |
Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
5004483 | NC | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | 8975633 | 05 |
Street Address |
4002 SPRING GARDEN ST SUITE C |
City | GREENSBORO |
State | NC |
Zip Code | 27407-1683 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205937851 | Hearthside Home Care, Inc. | Home Health | 4002 Spring Garden St, Ste A, Greensboro, NC 27407-1683 | 2006-09-26 |
1508328816 | Bethany Medical Center | Dermatology | 4002 Spring Garden St, Greensboro, NC 27407-1683 | 2019-04-04 |
1023342144 | Takela Naquay Anderson | Nurse Practitioner | 4002 Spring Garden St, Ste C, Greensboro, NC 27407-1683 | 2009-09-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093326019 | Marie Louise Phillips | Behavior Technician | 111 Domona Dr, Unit 6, Greensboro, NC 27407 | 2020-08-13 |
1306472709 | Blondine Yvonne Wynn | Home Health Aide | 2812 Apt 2g Vanstory Street, Greesboro, NC 27407 | 2020-03-17 |
1104452994 | Monyetta Marie Howell | Counselor | 2216 W. Meadowview Road, Wilmington Bldg. Suite 207, Greensboro, NC 27407 | 2020-03-12 |
1215456769 | Tiffany R. Wright | Massage Therapist | 317 H South Westgate Drive, Greensboro, NC 27407 | 2017-09-15 |
1992225676 | Kendra Edwards | Social Worker | 1 Centerview Dr Ste 103, Greensboro, NC 27407 | 2017-06-22 |
1477902674 | Triad Integrative Wellness Center Inc | Acupuncturist | 315j South Westgate Dr, Greensboro, NC 27407 | 2016-06-08 |
1083098354 | Kathryn Theall | Counselor | 1901 Adams Farm Pkwy, Greensboro, NC 27407 | 2015-07-16 |
1962886333 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 5710-w West Gate City Blvd, Greensboro, NC 27407 | 2015-07-16 |
1619356177 | Lindsey King | Registered Nurse | 302 Pomona Drive, Greensboro, NC 27407 | 2015-05-29 |
1255737664 | M.a.p.p.s. | Clinic/Center | 2216 West Meadowview Road Ste 204, Greensboro, NC 27407 | 2014-11-12 |
Find all providers in zip 27407 |
Taxonomy Code | 261QH0100X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Health Service |
Definition to come... |
Notes: [7/1/2006: modified title] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679041552 | Serenity Rehabilitation Services | Clinic/Center | 2216 W Meadowview Rd Ste 201, Greensboro, NC 27407-3401 | 2018-11-08 |
1144629833 | North Carolina A&t State University | Clinic/Center | 112 N Benbow Rd, Greensboro, NC 27411-0002 | 2014-08-19 |
1316139397 | Mohammad Lawal Garba, Md, Pa | Clinic/Center | 409g Parkway Avenue, Greensboro, NC 27401 | 2007-08-14 |
1720120637 | North Carolina A&t State University | Clinic/Center | 112 N. Benbow Road, Greensboro, NC 27411 | 2007-02-14 |
1942758412 | The University of North Carolina At Greensboro | Clinic/Center | 107 Gray Dr, Gove Student Health Center, Greensboro, NC 27412-5008 | 2016-09-14 |
1396001616 | The University of North Carolina At Greensboro | Clinic/Center | 107 Gray Dr, Gove Student Health Center, Greensboro, NC 27412-5008 | 2012-04-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407460603 | Fonshaunna Alston | Clinic/Center | 107 Grandimere Ct, Durham, NC 27703-9613 | 2020-09-04 |
1255949731 | New Life Peer Support and Coaching LLC | Clinic/Center | 3450 Toringdon Way, Suite 200, Charlotte, NC 28277 | 2020-07-21 |
1790306819 | Aeroflow Connect LLC | Clinic/Center | 3165 Sweeten Creek Rd, Asheville, NC 28803-2115 | 2020-04-29 |
1811518244 | Haven Total Wellness, Pllc | Clinic/Center | 149 Woodlawn St Suite C, West End, NC 27376 | 2020-04-27 |
1073156931 | Coastal Carolina Primary Care, Pllc | Clinic/Center | 15441 Us Highway 17 N Ste 501, Hampstead, NC 28443-0016 | 2019-10-23 |
1396303178 | Chiroduo | Clinic/Center | 6816 Ray Rd, Raleigh, NC 27613-3237 | 2019-06-05 |
1780147108 | Legacy Health Pa | Clinic/Center | 3049 Senna Dr, Matthews, NC 28105-6727 | 2019-04-11 |
1114496502 | Acupuncture Balanced Health | Clinic/Center | 112 Perkins Dr Ste 200, Chapel Hill, NC 27514-1786 | 2018-11-15 |
1972071884 | Our Health Lab Inc | Clinic/Center | 1411 Asheville Hwy, Hendersonville, NC 28791-2301 | 2018-11-08 |
1083125892 | Johnson Therapy Services | Clinic/Center | 10216 Perimeter Pkwy # 9, Charlotte, NC 28216-2461 | 2017-10-19 |
Find all providers with the same taxonomy |
City | GREENSBORO |
Zip Code | 27407 |
Please comment or provide details below to improve the information on PREMIUM WELLNESS AND PRIMARY CARE.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.