Premier Neuropsychiatry PLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301071405 Issued in MI

Legal business name

PREMIER NEUROPSYCHIATRY PLC

Practice address

5930 Lovers Lane
Portage, MI 49002

Phone

(269) 552-3900

Fax

(269) 488-3930

NPI assigned

Jul 16, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Mukesh Sanghadia, M.D.

Title

President

Phone

(269) 552-3900

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292889600000",
    "number": "1174836316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5930 LOVERS LANE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "49002",
            "telephone_number": "269-552-3900",
            "fax_number": "269-488-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5930 LOVERS LANE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "49002",
            "telephone_number": "269-552-3900",
            "fax_number": "269-488-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER NEUROPSYCHIATRY PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-16",
        "last_updated": "2010-12-21",
        "status": "A",
        "authorized_official_last_name": "SANGHADIA",
        "authorized_official_first_name": "MUKESH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-552-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301071405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4396230",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1366550246",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Portage, MI
• Providers in Portage, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; 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.