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PREMIERE HEALTH & WELLNESS LLC
NPI 1316658990
Nurse Practitioner - Family in Waycross, GA

Active since December 05, 2022CLIA 11D2276140 · Waiver
1710 1/2 ALICE ST, WAYCROSS, GA 31501(912) 809-2341(912) 809-2432 Get Directions Write a Review

NPPES record last updated: January 25, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 25, 2023, Dec 20, 2022, Dec 12, 2022 and 1 more (4 updates tracked since 2022).

About Premiere Health & Wellness Llc NPPES

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

PREMIERE HEALTH & WELLNESS LLC (NPI 1316658990) is a healthcare organization registered as a family in Waycross, Georgia and active in the NPI registry since December 2022. The organization holds a CLIA Waiver certificate valid through February 2, 2027 and lists Dawn Driggers, Owner, as its authorized official.

NPPES Registry Identity

NPI1316658990
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NamePREMIERE HEALTH & WELLNESS LLC
Location Address1710 1/2 ALICE STWaycross, GA 31501-5216
Mailing Address1710 1/2 Alice StWaycross, GA 31501-5216 · (912) 809-2341 · Fax (912) 809-2432
Phone(912) 809-2341
Fax(912) 809-2432
Organization SubpartNo
Authorized OfficialDawn DriggersOwner · (912) 614-3768
Enumeration DateDecember 5, 2022
Last NPPES UpdateJanuary 25, 20234 updates tracked since enumeration
NPPES CertifiedDecember 21, 2022
✔ NPI 1316658990 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
1710 1/2 ALICE ST, Waycross, GA 31501
Open in Google Maps ↗

Other Identifiers 1

Medicaid003206327AGA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Premiere Health & Wellness Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Premiere Health & Wellness LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Dawn Driggers, FNP
Nurse Practitioner
NPI 1063904217
1710 1/2 ALICE ST
Waycross, GA 31501
(912) 614-3768
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 11D2276140

Premiere Health & Wellness · Waycross, GA
Active · expires Feb 2, 2027
CLIA Number11D2276140
Laboratory TypePhysician Office
Certificate Effective DateFebruary 3, 2025
Certificate Expiration DateFebruary 2, 2027
Laboratory DirectorJeffrey Davenport
Laboratory Phone(912) 809-2341
Laboratory LocationPremiere Health & Wellness1710 1/2 Alice Street, Waycross, GA 31501
CLIA data matches this NPI record on: Address Name Phone
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 Premiere Health & Wellness LLC's NPI number?

The NPI number for Premiere Health & Wellness LLC is 1316658990. It was assigned to this organization in the NPPES registry on December 5, 2022.

Where is Premiere Health & Wellness LLC located?

Premiere Health & Wellness LLC is located at 1710 1/2 Alice St, Waycross, GA 31501. The listed phone number is (912) 809-2341.

What is Premiere Health & Wellness LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Premiere Health & Wellness LLC enrolled in Medicare?

Yes. Premiere Health & Wellness LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Premiere Health & Wellness LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Premiere Health & Wellness LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Premiere Health & Wellness LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2276140) is associated with this NPI, valid through February 2, 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 Premiere Health & Wellness LLC was last updated on January 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.