PREMIUM WELLNESS AND PRIMARY CARE
NPI 1336599547
Nurse Practitioner - Primary Care in Greensboro, NC

Active since June 18, 2016CLIA 34D2120159 · Waiver
308 POMONA DR STE A, GREENSBORO, NC 27407(336) 553-0793 Get Directions Write a Review

NPPES record last updated: July 12, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 12, 2024, Apr 4, 2024, Jun 18, 2016 (3 updates tracked since 2016).

About Premium Wellness And Primary Care NPPES

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

PREMIUM WELLNESS AND PRIMARY CARE (NPI 1336599547) is a healthcare organization registered as a primary care in Greensboro, North Carolina and active in the NPI registry since June 2016. The organization holds a CLIA Waiver certificate valid through June 17, 2028 and lists Monica Dianne Zellous, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1336599547
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NamePREMIUM WELLNESS AND PRIMARY CARE
Location Address308 POMONA DR STE AGreensboro, NC 27407-1644
Mailing Address308 Pomona Dr Ste AGreensboro, NC 27407-1644 · (336) 553-0793 · Fax (336) 553-0795
Organization SubpartNo
Authorized OfficialMonica Dianne ZellousPractice Manager · (336) 553-0793
Enumeration DateJune 18, 2016
Last NPPES UpdateJuly 12, 20243 updates tracked since enumeration
NPPES CertifiedJuly 12, 2024
NPI 1336599547 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
Also ListedClinic/Center · Health ServiceTaxonomy 261QH0100X · License 5004483 (NC), 5006433 (NC)
308 POMONA DR STE A, Greensboro, NC 27407

Other Identifiers 1

Medicaid8975633NC

Accepted Insurance

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 34D2120159

Premium Wellness And Primary Care · Greensboro, NC
Active · expires Jun 17, 2028
CLIA Number34D2120159
Laboratory TypePractitioner Other
Certificate Effective DateJune 18, 2026
Certificate Expiration DateJune 17, 2028
Laboratory DirectorJohn Z. Hall
Laboratory Phone(336) 553-0793
Laboratory LocationPremium Wellness And Primary Care308 Pomona Dr Ste A, Greensboro, NC 27407
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Non-emergency Medical Transport (VAN)
308 POMONA DR STE A
GREENSBORO, NC 27407
Community/Behavioral Health
308 POMONA DR STE A
GREENSBORO, NC 27407

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 Premium Wellness And Primary Care's NPI number?

The NPI number for Premium Wellness And Primary Care is 1336599547. It was assigned to this organization in the NPPES registry on June 18, 2016.

Where is Premium Wellness And Primary Care located?

Premium Wellness And Primary Care is located at 308 Pomona Dr Ste A, Greensboro, NC 27407. The listed phone number is (336) 553-0793.

What is Premium Wellness And Primary Care's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Does Premium Wellness And Primary Care hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2120159) is associated with this NPI, valid through June 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Premium Wellness And Primary Care accept?

Health plans from Blue Cross and Blue Shield of NC list Premium Wellness And Primary Care as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Premium Wellness And Primary Care was last updated on July 12, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.