Active NPI
Premier Family Health Care Services LLC
- Mental Health Counselor
- Roanoke Rapids, NC
National Provider Identifier
1124191119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- PREMIER FAMILY HEALTH CARE SERVICES LLC
- Practice address
- 1704 Hwy 158
Roanoke Rapids, NC 27870-8378 - Phone
- (252) 519-2273
- Fax
- (252) 535-2399
- NPI assigned
- Nov 16, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Stacie Medlin Shearin, MSW
- Title
- President / Owner
- Phone
- (252) 519-2273
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary | ||
| Community/Behavioral Health Agency | 251S00000X |
Addresses
Primary practice location
1704 Hwy 158
Roanoke Rapids, NC 27870-8378
Mailing address
1704 Hwy 158
Roanoke Rapids, NC 27870-8378
Phone (252) 519-2273
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6005402 | Medicaid | NC | |
| 5904750 | Medicaid | NC |
National Provider Directory
National Provider Directory- Tax ID family
- Premier Family Health Care Services LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Roanoke Rapids, NC
- NPI 1679608541
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1242864000000",
"number": "1124191119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1704 HWY 158",
"city": "ROANOKE RAPIDS",
"state": "NC",
"postal_code": "278708378",
"telephone_number": "252-519-2273",
"fax_number": "252-535-2399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1704 HWY 158",
"city": "ROANOKE RAPIDS",
"state": "NC",
"postal_code": "278708378",
"telephone_number": "252-519-2273",
"fax_number": "252-535-2399"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREMIER FAMILY HEALTH CARE SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-16",
"last_updated": "2009-05-21",
"status": "A",
"authorized_official_last_name": "SHEARIN",
"authorized_official_first_name": "STACIE",
"authorized_official_middle_name": "MEDLIN",
"authorized_official_title_or_position": "PRESIDENT / OWNER",
"authorized_official_telephone_number": "252-519-2273",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "MSW"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6005402",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5904750",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roanoke Rapids, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.