Premier OB-GYN PLLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

40865 Issued in CO

Legal business name

PREMIER OB-GYN PLLC

Practice address

9195 Grant St
Suite 400
Thornton, CO 80229-4385

Phone

(303) 854-3681

Fax

(303) 426-4154

NPI assigned

Mar 16, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stacey Hennesy

Title

MD

Phone

(303) 854-3681

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264723200000",
    "number": "1003057456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9195 GRANT ST",
            "address_2": "SUITE 400",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294385",
            "telephone_number": "303-854-3681",
            "fax_number": "303-426-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9195 GRANT ST",
            "address_2": "SUITE 400",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294385",
            "telephone_number": "303-854-3681",
            "fax_number": "303-426-4154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER OB-GYN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-16",
        "last_updated": "2010-01-29",
        "status": "A",
        "authorized_official_last_name": "HENNESY",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "303-854-3681"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "40865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "72507560",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin Poznic, OD
• Devrath Manohar Prabhu
• Francisco Prada, MD
• Kelly Johanna Prado, PMHNP
• Alexandra Claire Prehn
• Premier Occ Med PLLC
• Heather Daphne Prestridge, CPM
• Paul O. Price
• Yesenia Prieto, DH
• Sean Michael Primus, D.C.

• Obstetrics & Gynecology Physician in Thornton, CO
• Providers in Thornton, CO by specialty
• Obstetrics & Gynecology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.