NPIMap

Organization Active NPI

Premier Healthcare Services, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Dartmouth, MA
National Provider Identifier
1174089163
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
PREMIER HEALTHCARE SERVICES, LLC
Practice address
77 Wolcott Ave
Dartmouth, MA 02747-2459
Phone
(774) 202-7049
Fax
(774) 202-2839
NPI assigned
Feb 14, 2019
Last updated
Feb 14, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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

Authorized official

Name
William Thornson, PA-CNPI 1750369278
Title
Partner/Owner
Phone
(774) 202-7049

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X Primary

Addresses

Primary practice location

77 Wolcott Ave
Dartmouth, MA 02747-2459

Mailing address

85 E Main St
Fall River, MA 02724-3348
Phone (774) 526-4241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190528001748 MA Part B Supplier - Clinic/Group Practice 9931442381 Receives reassigned benefits from 23 practitioners
Practice locations: New Bedford, MA

National Provider Directory

National Provider Directory

Locations

77 Wolcott Ave
North Dartmouth, MA 02747
Phone (508) 999-1502

Practitioners & affiliated clinicians

Practitioners 52

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.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550102400000",
    "number": "1174089163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 E MAIN ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027243348",
            "telephone_number": "774-526-4241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 WOLCOTT AVE",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027472459",
            "telephone_number": "774-202-7049",
            "fax_number": "774-202-2839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HEALTHCARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-14",
        "last_updated": "2019-02-14",
        "status": "A",
        "authorized_official_last_name": "THORNSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PARTNER/OWNER",
        "authorized_official_telephone_number": "774-202-7049",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dartmouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; 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.