SOUTHFIELD PREMIER PRIMARY CARE PLLC
NPI 1417682766
Clinic/Center - Primary Care in Southfield, MI
About Southfield Premier Primary Care Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHFIELD PREMIER PRIMARY CARE PLLC (NPI 1417682766) is a healthcare organization registered as a primary care in Southfield, Michigan and active in the NPI registry since July 2022. The organization holds a CLIA Waiver certificate valid through August 21, 2027 and lists Rafid Mansour, Medical Director/physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
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 23D2288150
Southfield Premier Primary Care PLLC · Southfield, MIOther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SOUTHFIELD, MI 48076
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 Southfield Premier Primary Care PLLC's NPI number?
The NPI number for Southfield Premier Primary Care PLLC is 1417682766. It was assigned to this organization in the NPPES registry on July 20, 2022.
Where is Southfield Premier Primary Care PLLC located?
Southfield Premier Primary Care PLLC is located at 17070 W 12 Mile Rd Ste A, Southfield, MI 48076. The listed phone number is (248) 559-2280.
What is Southfield Premier Primary Care PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Does Southfield Premier Primary Care PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 23D2288150) is associated with this NPI, valid through August 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Southfield Premier Primary Care PLLC accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Southfield Premier Primary Care PLLC 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 Southfield Premier Primary Care PLLC was last updated on July 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Southfield Premier Primary Care Pllc · NPI 1417682766
Primary Care organization in Southfield, Michigan. Organization record, active in the CMS NPPES registry since July 20, 2022.
## Identity
- **NPI:** 1417682766 (Entity type: Organization)
- **Enumerated:** July 20, 2022
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Rafid Mansour, MEDICAL DIRECTOR/PHYSICIAN
## Practice location
- **Address:** 17070 W 12 MILE RD STE A, Southfield, MI 48076-2116
- **Phone:** (248) 559-2280 · **Fax:** (248) 559-3752
## Record status
- **NPPES last updated:** July 20, 2022
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1417682766) · Data from the CMS NPPES public registry.