NPIMap

Organization Active NPI

Premiere Pediatrics, PC

  • Pediatrics Physician
  • Clarkston, MI
National Provider Identifier
1134291982
Registry record updated Apr 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PREMIERE PEDIATRICS, PC
Practice address
7210 N Main St
Suite 205
Clarkston, MI 48346-1575
Phone
(248) 625-9755
Fax
(248) 620-9334
NPI assigned
Nov 15, 2006
Last updated
Apr 16, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2012

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

Authorized official

Name
James Charles Shaya, M.D.NPI 1659307619
Title
President
Phone
(248) 625-9755

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

7210 N Main St
Suite 205
Clarkston, MI 48346-1575

Mailing address

7210 N Main St
Suite 205
Clarkston, MI 48346-1575
Phone (248) 625-9755

National Provider Directory

National Provider Directory

Locations

7210 N Main St
Ste 205
Clarkston, MI 48346
Phone (248) 625-9755

Practitioners & affiliated clinicians

Practitioners 4

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": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334534400000",
    "number": "1134291982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7210 N MAIN ST",
            "address_2": "SUITE 205",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483461575",
            "telephone_number": "248-625-9755",
            "fax_number": "248-620-9334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7210 N MAIN ST",
            "address_2": "SUITE 205",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483461575",
            "telephone_number": "248-625-9755",
            "fax_number": "248-620-9334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2012-04-16",
        "status": "A",
        "authorized_official_last_name": "SHAYA",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-625-9755",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2012; 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.