Premier 1 Healthcare LLC

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

Legal business name

PREMIER 1 HEALTHCARE LLC

Practice address

928 E 5TH St N
Big Stone Gap, VA 24219-2435

Phone

(276) 524-1906

Fax

(276) 524-1908

NPI assigned

Oct 10, 2017

Organization subpart

No

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

Authorized official

Name

Spencer Kelly Bowman

Title

Ceo

Phone

(276) 524-1906

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507593600000",
    "number": "1225548860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 E 5TH ST N",
            "city": "BIG STONE GAP",
            "state": "VA",
            "postal_code": "242192435",
            "telephone_number": "276-524-1906",
            "fax_number": "276-524-1908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 E 5TH ST N",
            "city": "BIG STONE GAP",
            "state": "VA",
            "postal_code": "242192435",
            "telephone_number": "276-524-1906",
            "fax_number": "276-524-1908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER 1 HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-10",
        "last_updated": "2017-10-10",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_middle_name": "KELLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "276-524-1906"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Phillips
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• Brittany Potter, PHARMD
• Morgan Paige Powers, FNP
• Shaine Powers, DO
• Jason Matthew Price
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• Connie Louise Ramsey, BACHELOR OF ARTS AS
• Ethel Mae Reese, RN

• Addiction Medicine (Family Medicine) Physician in Big Stone Gap, VA
• Providers in Big Stone Gap, VA by specialty
• Addiction Medicine (Family Medicine) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; 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.