NPIMap

Organization Active NPI

Premise Health of North Carolina Medical, P.C

Doing business as Maxton Occupational Health Clinic

  • Occupational Medicine Clinic/Center
  • Maxton, NC
National Provider Identifier
1225465677
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X
Legal business name
PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C
Doing business as
Maxton Occupational Health Clinic
Practice address
2120 NC 71 Highway North
Maxton, NC 28364-9433
Phone
(910) 844-1236
Fax
(910) 844-1349
NPI assigned
Oct 1, 2013
Last updated
Aug 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Authorized official

Name
Jon Leizman Jr., M.D.
Title
President
Phone
(216) 479-9063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Clinic/Center 261QX0100X NU Primary

Addresses

Primary practice location

2120 NC 71 Highway North
Maxton, NC 28364-9433

Mailing address

5500 Maryland Way
Brentwood, TN 37027-4948
Phone (910) 844-1236

Other names 1

  • Maxton Occupational Health Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of North Carolina Medical PC54 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

Locations

2120 NC Highway 71 N
Maxton, NC 28364
Phone (910) 844-1236

NPI Registry JSON

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1225465677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274948",
            "telephone_number": "910-844-1236",
            "fax_number": "910-844-1349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 NC 71 HIGHWAY NORTH",
            "city": "MAXTON",
            "state": "NC",
            "postal_code": "283649433",
            "telephone_number": "910-844-1236",
            "fax_number": "910-844-1349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-01",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-479-9063",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maxton Occupational Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maxton Occupational Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maxton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.