Premise Health of North Carolina Medical, P.C
Organization Active NPI Occupational Medicine Clinic/Center · Norwood, NC
NPI 1124452586 · NPPES record last updated Aug 24, 2022
Key facts
- NPI
- 1124452586
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Occupational Medicine Clinic/Center 261QX0100X
- Legal business name
- PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C
- Practice address
- 40589 S Stanly School Rd
Norwood, NC 28128-8752 - Phone
- (704) 474-2011
- Fax
- (704) 784-8179
- NPI assigned
- Aug 21, 2013
- Organization subpart
- No
Authorized official
- Name
- Jon Leizman, M.D.
- Title
- President
- Phone
- (216) 479-9063
Corporate family (same tax ID) 18
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2063218 | Premise Health of North Carolina Medical, PC | Certificate of waiver | Jul 29, 2027 |
National Provider Directory
- Tax ID family
- Premise Health of North Carolina Medical PC
Locations
40589 S Stanly School Rd
Norwood, NC 28128
Phone (704) 474-2011
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Medicine Clinic/Center | 261QX0100X | Yes |
Addresses
Primary practice location
40589 S Stanly School Rd
Norwood, NC 28128-8752
Mailing address
5500 Maryland Way
Brentwood, TN 37027-4948
Phone (704) 474-2011
Other names
- US11 Michelin Occupational Health Clinic
Other providers in Norwood, NC
- April Dawn Nickel
- Norwood, Lassiter and Associates
- W. Thomas Norwood
- Kyla Palmer
- Rachael Peoples
- Shay Russell
- Vulnavia Scales
- Nichole Schenck
- Summer Patterson Shelton
- Martina Siemon
All providers in Norwood, NC · Occupational Medicine Clinic/Center in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.