Premiere Pediatrics PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PREMIERE PEDIATRICS PLLC

Practice address

703 E Marshall Ave Ste 4002
Longview, TX 75601-5622

Phone

(903) 315-3966

Fax

(903) 230-0795

NPI assigned

Mar 24, 2023

Organization subpart

No

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

Authorized official

Name

Samantha Jayne Roworth-Chaikin, DONPI 1295712719

Title

Physician Owner

Phone

(903) 315-3966

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 6

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

• Samantha Jayne Roworth-Chaikin, DO

  • Pediatrics Physician
  • Longview, TX
  • NPI 1295712719
  Medicare reassignment NPD Authorized official
• Heather Anne Dean, APRN-CNP

  • Family Nurse Practitioner
  • Henderson, TX
  • NPI 1275350373
  Medicare reassignment NPD
• Tori Johnston, FNP-C

  • Family Nurse Practitioner
  • Tyler, TX
  • NPI 1952947350
  Medicare reassignment NPD
• Kristi Nealy, P.A.

  • Medical Physician Assistant
  • Longview, TX
  • NPI 1386642734
  Medicare reassignment NPD
• Jennifer Morgan Tarr, RN, APRN, FNP-C

  • Family Nurse Practitioner
  • Longview, TX
  • NPI 1306428537
  Medicare reassignment NPD
• Jean Rene Yates-Halbert, P.A.-C.

  • Medical Physician Assistant
  • Hallsville, TX
  • NPI 1831197342
  Medicare reassignment

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

{
    "created_epoch": "1679616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679616000000",
    "number": "1124721410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 E MARSHALL AVE STE 4002",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015622",
            "telephone_number": "903-315-3966",
            "fax_number": "903-230-0795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 E MARSHALL AVE STE 4002",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015622",
            "telephone_number": "903-315-3966",
            "fax_number": "903-230-0795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-24",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A",
        "authorized_official_last_name": "ROWORTH-CHAIKIN",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "JAYNE",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "903-315-3966",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Elizabeth Pratt, PA-C
• Precious Hand'S
• Precision Assistiants PLLC
• Precision Hearing Group Inc.
• Premier Pediatrics
• Prestige Imaging, LLC
• Clinton Conell Price, M.D.
• Prime Care Hospice LLC
• Prime Care Managers, LLC
• Amanda J Prince Chen, CPNP

• Pediatrics Physician in Longview, TX
• Providers in Longview, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; 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.