JAX PREMIER HEALTH CENTER PLLC
NPI 1902612898
Internal Medicine in Jacksonville, FL

Active since December 05, 2024CLIA 10D2316144 · Waiver
9010 R G SKINNER PKWY, JACKSONVILLE, FL 32256(347) 469-7633 Get Directions Write a Review

NPPES record last updated: December 5, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jax Premier Health Center Pllc NPPES

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

JAX PREMIER HEALTH CENTER PLLC (NPI 1902612898) is a healthcare organization registered as an internal medicine in Jacksonville, Florida and active in the NPI registry since December 2024. The organization holds a CLIA Waiver certificate valid through December 29, 2026 and lists Al Berry, Manager, as its authorized official.

NPPES Registry Identity

NPI1902612898
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameJAX PREMIER HEALTH CENTER PLLC
Location Address9010 R G SKINNER PKWYJacksonville, FL 32256-4157
Mailing Address9010 R G Skinner PkwyJacksonville, FL 32256-4157 · (347) 469-7633
Organization SubpartNo
Authorized OfficialAl BerryManager · (469) 915-4211
Enumeration DateDecember 5, 2024
NPPES CertifiedDecember 5, 2024
NPI 1902612898 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

9010 R G SKINNER PKWY, Jacksonville, FL 32256

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

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 10D2316144

Jax Premier Health Center PLLC · Jacksonville, FL
Active · expires Dec 29, 2026
CLIA Number10D2316144
Laboratory TypePhysician Office
Certificate Effective DateDecember 30, 2024
Certificate Expiration DateDecember 29, 2026
Laboratory DirectorMameyan Donzo
Laboratory Phone(347) 469-7633
Laboratory LocationJax Premier Health Center PLLC9050 Cypress Green Drive Suite 104, Jacksonville, FL 32256
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

Massage Therapist
9010 R G SKINNER PKWY
JACKSONVILLE, FL 32256
Clinic/Center
9010 R G SKINNER PKWY
JACKSONVILLE, FL 32256
Massage Therapist
9010 R G SKINNER PKWY
JACKSONVILLE, FL 32256
Chiropractor
9010 R G SKINNER PKWY
JACKSONVILLE, FL 32256

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 Jax Premier Health Center PLLC's NPI number?

The NPI number for Jax Premier Health Center PLLC is 1902612898. It was assigned to this organization in the NPPES registry on December 5, 2024.

Where is Jax Premier Health Center PLLC located?

Jax Premier Health Center PLLC is located at 9010 R G Skinner Pkwy, Jacksonville, FL 32256. The listed phone number is (347) 469-7633.

What is Jax Premier Health Center PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Jax Premier Health Center PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2316144) is associated with this NPI, valid through December 29, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Jax Premier Health Center PLLC accept?

Health plans from Molina Healthcare list Jax Premier Health Center 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 Jax Premier Health Center PLLC was last updated on December 5, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.