NPIMap

Organization Active NPI

Premier Physicians Centers, Inc.

Doing business as Sleep Center at Southwest General Health Center

  • Sleep Disorder Diagnostic Clinic/Center
  • Middleburg Heights, OH
National Provider Identifier
1104412477
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X
Legal business name
PREMIER PHYSICIANS CENTERS, INC.
Doing business as
Sleep Center at Southwest General Health Center
Practice address
18697 Bagley Rd # A317
Middleburg Heights, OH 44130-3417
Phone
(440) 816-6030
Fax
(440) 816-4268
NPI assigned
Dec 21, 2020
Last updated
Dec 21, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
PREMIER PHYSICIANS CENTERS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 21, 2020

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

Authorized official

Name
Charles Mica
Title
Coo
Phone
(440) 895-5057

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Disorder Diagnostic Clinic/Center 261QS1200X Primary

Addresses

Primary practice location

18697 Bagley Rd # A317
Middleburg Heights, OH 44130-3417

Mailing address

24500 Center Ridge Rd Ste 375
Westlake, OH 44145-5631
Phone (440) 895-5010

Other names 1

  • Sleep Center at Southwest General Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000335 OH Part B Supplier - Clinic/Group Practice 0345153326 Receives reassigned benefits from 55 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: North Olmsted, OH; Norwalk, OH; Rocky River, OH; Westlake, OH; Cleveland, OH; Middleburg Heights, OH; Brooklyn, OH; Elyria, OH…

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Premier Physicians Centers Inc14 organizations share this tax ID, including this one
Part of
Premier Physicians Centers Inc

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

18697 Bagley Rd
#A317
Middleburg Heights, OH 44130
Phone (440) 816-6030

24500 Center Ridge Rd
Ste 375
Westlake, OH 44145
Phone (440) 467-1954

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1608508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608508800000",
    "number": "1104412477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24500 CENTER RIDGE RD STE 375",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455631",
            "telephone_number": "440-895-5010",
            "fax_number": "440-895-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18697 BAGLEY RD # A317",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303417",
            "telephone_number": "440-816-6030",
            "fax_number": "440-816-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PHYSICIANS CENTERS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER PHYSICIANS CENTERS, INC.",
        "enumeration_date": "2020-12-21",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A",
        "authorized_official_last_name": "MICA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "440-895-5057"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sleep Center at Southwest General Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middleburg Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; 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.