Premier OB-GYN LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

04-30709 Issued in KS

Legal business name

PREMIER OB-GYN LLC

Practice address

514 Cleveland St
Great Bend, KS 67530-3562

Phone

(620) 792-2151

Fax

(620) 793-9399

NPI assigned

Dec 1, 2015

Last updated

Dec 1, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jodi L Henrikson, MDNPI 1821063652

Title

Physician

Phone

(620) 792-2151

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Jodi Henrikson, MD

  • Obstetrics & Gynecology Physician
  • Great Bend, KS
  • NPI 1821063652
  Authorized official Same address or phone

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448928000000",
    "number": "1184098212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 CLEVELAND ST",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303562",
            "telephone_number": "620-792-2151",
            "fax_number": "620-793-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 CLEVELAND ST",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303562",
            "telephone_number": "620-792-2151",
            "fax_number": "620-793-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER OB-GYN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-01",
        "last_updated": "2015-12-01",
        "status": "A",
        "authorized_official_last_name": "HENRIKSON",
        "authorized_official_first_name": "JODI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "620-792-2151",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KS",
            "license": "04-30709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vivian J Pfister, LSCSW
• Jonathan Pike, M.D.
• Jessica A Poe, PTA
• Prairie Dental Associates
• Chad T Premer, O.D.
• Jessica Shea Pries, MD
• Jean Pringle, M.D.
• Sherry K Pruter, LPC
• Daniel Quillin
• Cheryl Ralston, PTA

• Obstetrics & Gynecology Physician in Great Bend, KS
• Providers in Great Bend, KS by specialty
• Obstetrics & Gynecology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; 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.