Premier Pediatrics, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D0057446 Issued in MD

Legal business name

PREMIER PEDIATRICS, LLC

Practice address

7310 Ritchie Hwy
Suite 516
Glen Burnie, MD 21061

Phone

(410) 761-7305

Fax

(410) 761-7387

NPI assigned

Jan 3, 2014

Organization subpart

No

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

Authorized official

Name

Shannon Lane West, M.D.

Title

President

Phone

(410) 761-7305

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1388707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388707200000",
    "number": "1124449491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7310 RITCHIE HWY",
            "address_2": "SUITE 516",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-761-7305",
            "fax_number": "410-761-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7310 RITCHIE HWY",
            "address_2": "SUITE 516",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-761-7305",
            "fax_number": "410-761-7387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-03",
        "last_updated": "2014-01-03",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "LANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-761-7305",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0057446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "776200300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Uma Prabhakar, M.D.
• Harini Sankhavaram Prasanna, M.D
• Precious Soul Healthcare LLC
• Preferred Care Center
• Preferred Care Center of Glen Burnie LLC
• Premium Care Servies Inc.
• Kathleen Prendergast, MD
• Mark W Preslan, MD
• Christopher D Presley, NP
• Jean Marie Preston, LPN

• Pediatrics Physician in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; 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.