Premium Petal LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

PREMIUM PETAL LLC

Doing business as

Premium Petal Medical Services

Practice address

13663 Van Doren Rd
Manassas, VA 20112-3804

Phone

(804) 501-9127

NPI assigned

Jul 2, 2025

Organization subpart

No

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

Authorized official

Name

Khadijah Marshall

Title

Owner

Phone

(804) 501-9127

Specialties & licenses 2

Addresses

Other names 1

• Premium Petal Medical Services Doing business as

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

{
    "created_epoch": "1751414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751414400000",
    "number": "1225927304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13663 VAN DOREN RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201123804",
            "telephone_number": "804-501-9127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13663 VAN DOREN RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201123804",
            "telephone_number": "804-501-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM PETAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-02",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "KHADIJAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-501-9127"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premium Petal Medical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Premier Healthcare Group LLC
• Premise Health of Connecticut Medical, P.C.
• Premise Health of Virginia Medical PC
• Premise Health of Virginia Medical PC
• Premise Health of Virginia Medical, P.C
• Amy Prestidge
• Sarah Preston
• Lindy Prevatt, NP
• Douglas S Price, MD
• Laura Marie Price, BCBA, LBA

• Non-emergency Medical Transport (VAN) in Manassas, VA
• Providers in Manassas, VA by specialty
• Non-emergency Medical Transport (VAN) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; 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.