THE WELLNESS CENTER OPERATED BY PREMISE HEALTH
NPI 1942956842
Clinic/Center - Multi-Specialty in Bridgeport, CT

Active since March 01, 2022CLIA 07D2260282 · Waiver
1210 SOUTH AVE, BRIDGEPORT, CT 06604(203) 224-2073 Get Directions Write a Review

NPPES record last updated: August 15, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 15, 2022, Jul 13, 2022, Mar 1, 2022 (3 updates tracked since 2022).

About The Wellness Center Operated By Premise Health NPPES

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

THE WELLNESS CENTER OPERATED BY PREMISE HEALTH (NPI 1942956842) is a healthcare organization registered as a multi-specialty in Bridgeport, Connecticut and active in the NPI registry since March 2022. The organization holds a CLIA Waiver certificate valid through May 16, 2028 and lists Jonathan Leizman, President, as its authorized official.

NPPES Registry Identity

NPI1942956842
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NamePREMISE HEALTH OF CONNECTICUT MEDICAL, P.C.
Location Address1210 SOUTH AVEBridgeport, CT 06604-5243
Mailing Address5500 Maryland Way Ste 120Brentwood, TN 37027-4993
Organization SubpartNo
Authorized OfficialJonathan LeizmanPresident · (216) 479-9063
Enumeration DateMarch 1, 2022
Last NPPES UpdateAugust 15, 20223 updates tracked since enumeration
NPPES CertifiedAugust 15, 2022
NPI 1942956842 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
1210 SOUTH AVE, Bridgeport, CT 06604

Other Names 1

Doing Business AsThe Wellness Center Operated By Premise Health

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 07D2260282

Premise Health Of Connecticut Medical, PC · Bridgeport, CT
Active · expires May 16, 2028
CLIA Number07D2260282
Laboratory TypePhysician Office
Certificate Effective DateMay 17, 2026
Certificate Expiration DateMay 16, 2028
Laboratory DirectorLeslie Blum
Laboratory Phone(203) 224-2073
Laboratory LocationPremise Health Of Connecticut Medical, PC1210 South Ave, Bridgeport, CT 06601
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 Premise Health Of Connecticut Medical, P.C.'s NPI number?

The NPI number for Premise Health Of Connecticut Medical, P.C. is 1942956842. It was assigned to this organization in the NPPES registry on March 1, 2022. The provider is doing business as The Wellness Center Operated By Premise Health.

Where is Premise Health Of Connecticut Medical, P.C. located?

Premise Health Of Connecticut Medical, P.C. is located at 1210 South Ave, Bridgeport, CT 06604. The listed phone number is (203) 224-2073.

What is Premise Health Of Connecticut Medical, P.C.'s specialty?

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

Does Premise Health Of Connecticut Medical, P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D2260282) is associated with this NPI, valid through May 16, 2028. 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 Connecticut Medical, P.C. was last updated on August 15, 2022. 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.