Premier Healthcare STL LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PREMIER HEALTHCARE STL LLC

Practice address

703 Hesemann Ridge CT
Ballwin, MO 63021-3602

Phone

(636) 751-0362

NPI assigned

Sep 27, 2019

Organization subpart

No

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

Authorized official

Name

Mohammad Amin Zaman, MDNPI 1346350196

Title

President

Phone

(636) 751-0362

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohammad Amin Zaman, MD

  • Internal Medicine Physician
  • Burr Ridge, IL
  • NPI 1346350196

  MO

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569542400000",
    "number": "1053962357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 HESEMANN RIDGE CT",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630213602",
            "telephone_number": "636-751-0362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 HESEMANN RIDGE CT",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630213602",
            "telephone_number": "636-751-0362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HEALTHCARE STL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-27",
        "last_updated": "2019-09-27",
        "status": "A",
        "authorized_official_last_name": "ZAMAN",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "AMIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-751-0362",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Ballwin, MO
• Providers in Ballwin, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; 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.