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PREMISE HEALTH OF ALABAMA MEDICAL PC
NPI 1104284405
Clinic/Center - Multi-Specialty in Prattville, AL

Active since February 02, 2016CLIA 01D2020421 · Waiver
100 JENSEN RD, PRATTVILLE, AL 36067(334) 361-5568(334) 365-5623 Get Directions Write a Review

NPPES record last updated: September 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 25, 2022, Feb 2, 2016 (2 updates tracked since 2016).

About Premise Health Of Alabama Medical Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PREMISE HEALTH OF ALABAMA MEDICAL PC (NPI 1104284405), doing business as Ip Prattville Mill Health Center, is a healthcare organization registered as a multi-specialty in Prattville, Alabama and active in the NPI registry since February 2016. The organization holds a CLIA Waiver certificate valid through February 16, 2027 and lists Jon Leizman, President, as its authorized official.

NPPES Registry Identity

NPI1104284405
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NamePREMISE HEALTH OF ALABAMA MEDICAL PC
Location Address100 JENSEN RDPrattville, AL 36067-4868
Mailing Address5500 Maryland Way Ste 120Brentwood, TN 37027-4993 · (334) 361-5568 · Fax (334) 365-5623
Phone(334) 361-5568
Fax(334) 365-5623
Organization SubpartNo
Authorized OfficialJon LeizmanPresident · (216) 479-9063
Enumeration DateFebruary 2, 2016
Last NPPES UpdateSeptember 24, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 24, 2025
✔ NPI 1104284405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
100 JENSEN RD, Prattville, AL 36067
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Other Names 1

Doing Business AsIp Prattville Mill Health Center

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 01D2020421

Premise Health Of Alabama Medical, P C · Prattville, AL
Active · expires Feb 16, 2027
CLIA Number01D2020421
Laboratory TypePhysician Office
Certificate Effective DateFebruary 17, 2025
Certificate Expiration DateFebruary 16, 2027
Laboratory DirectorDr. Robert Nichols
Laboratory Phone(334) 553-8779
Laboratory LocationPremise Health Of Alabama Medical, P C135 Tichnor Avenue, Prattville, AL 36067
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Premise Health Of Alabama Medical PC's NPI number?

The NPI number for Premise Health Of Alabama Medical PC is 1104284405. It was assigned to this organization in the NPPES registry on February 2, 2016. The provider is doing business as IP Prattville Mill Health Center.

Where is Premise Health Of Alabama Medical PC located?

Premise Health Of Alabama Medical PC is located at 100 Jensen Rd, Prattville, AL 36067. The listed phone number is (334) 361-5568.

What is Premise Health Of Alabama Medical PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Premise Health Of Alabama Medical PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 01D2020421) is associated with this NPI, valid through February 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Premise Health Of Alabama Medical PC was last updated on September 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.