NPIMap

Organization Active NPI

Premier Psychiatric Solutions PLLC

  • Psychiatry Physician
  • Roanoke, VA
National Provider Identifier
1053000430
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PREMIER PSYCHIATRIC SOLUTIONS PLLC
Practice address
6701 Peters Creek Rd Ste 110
Roanoke, VA 24019-4060
Phone
(800) 765-7130
NPI assigned
May 2, 2023
Last updated
May 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Authorized official

Name
Bradley J Goad, DONPI 1285617241
Title
Owner
Phone
(540) 488-2200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

6701 Peters Creek Rd Ste 110
Roanoke, VA 24019-4060

Mailing address

6701 Peters Creek Rd Ste 110
Roanoke, VA 24019-4060
Phone (800) 765-7130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230517002586 VA Part B Supplier - Clinic/Group Practice 7012373020 Receives reassigned benefits from 17 practitioners
Practice locations: Roanoke, VA
O20240227002872 NC Part B Supplier - Clinic/Group Practice 7012373020 Receives reassigned benefits from 3 practitioners
Practice locations: Mount Airy, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684281600000",
    "number": "1053000430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 PETERS CREEK RD STE 110",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240194060",
            "telephone_number": "800-765-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 PETERS CREEK RD STE 110",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240194060",
            "telephone_number": "800-765-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PSYCHIATRIC SOLUTIONS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A",
        "authorized_official_last_name": "GOAD",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-488-2200",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.