NPIMap

Organization Active NPI

Premieant Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Austin, TX
National Provider Identifier
1144323502
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
3647 Issued in TX
Legal business name
PREMIEANT INC
Practice address
1203 Echo Lane
Austin, TX 78745
Phone
(512) 916-1632
Fax
(512) 916-1639
NPI assigned
Sep 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Dennis R Latimer
Title
Ceo
Phone
(512) 916-1632

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 3647 TX Primary

Addresses

Primary practice location

1203 Echo Lane
Austin, TX 78745

Mailing address

1110 West William Cannon
Building 2
Austin, TX 78745
Phone (512) 916-1632

Other names 1

  • Wagon Crossing Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 45G365

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
WAGON CROSSING
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Feb 27, 1990
Last certification
Feb 27, 2025
Beds
6
Ownership / control type
Private (non-profit)
Facility address
1203 Echo LN
Austin, TX 78745

National Provider Directory

National Provider Directory
Tax ID family
Premient Inc28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144323502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 WEST WILLIAM CANNON",
            "address_2": "BUILDING 2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78745",
            "telephone_number": "512-916-1632",
            "fax_number": "512-916-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 ECHO LANE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78745",
            "telephone_number": "512-916-1632",
            "fax_number": "512-916-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIEANT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LATIMER",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-916-1632",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "TX",
            "license": "3647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wagon Crossing",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.