Organization Active NPI

Premier Health and Medical

  • Adult Health Nurse Practitioner
  • Queen Creek, AZ
National Provider Identifier
1184087579
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP2911 Issued in AZ
Legal business name
PREMIER HEALTH AND MEDICAL
Practice address
20851 E Rittenhouse Rd
E103
Queen Creek, AZ 85142-4493
Phone
(480) 677-2800
NPI assigned
Apr 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Authorized official

Name
Brett BakerNPI 1093954893
Title
Owner
Phone
(480) 707-1398

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 8038 AZ
Adult Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LA2200X AP2911 AZ Primary

Addresses

Primary practice location

20851 E Rittenhouse Rd
E103
Queen Creek, AZ 85142-4493

Mailing address

20851 E Rittenhouse Rd
E103
Queen Creek, AZ 85142-4493
Phone (480) 677-2800

National Provider Directory

National Provider Directory

Locations

20851 E Rittenhouse Rd
#E103
Queen Creek, AZ 85142
Phone (480) 677-2800

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473292800000",
    "number": "1184087579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20851 E RITTENHOUSE RD",
            "address_2": "E103",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851424493",
            "telephone_number": "480-677-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20851 E RITTENHOUSE RD",
            "address_2": "E103",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851424493",
            "telephone_number": "480-677-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HEALTH AND MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-01",
        "last_updated": "2016-09-08",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-707-1398"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8038",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP2911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.