Premier Physicians of Central Ohio, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35087348 Issued in OH

Legal business name

PREMIER PHYSICIANS OF CENTRAL OHIO, LLC

Practice address

4075 W Dublin Granville Rd
Dublin, OH 43017-1436

Phone

(614) 210-0541

NPI assigned

Jun 20, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Sarah Hope Bonza, M.D.

Title

Medical Director

Phone

(614) 813-0764

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406073600000",
    "number": "1245645993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3136 KINGSDALE CTR STE 126",
            "city": "UPPER ARLINGTON",
            "state": "OH",
            "postal_code": "432212000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4075 W DUBLIN GRANVILLE RD",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430171436",
            "telephone_number": "614-210-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PHYSICIANS OF CENTRAL OHIO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-20",
        "last_updated": "2014-07-23",
        "status": "A",
        "authorized_official_last_name": "BONZA",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "HOPE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "614-813-0764",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35087348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2780647",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alisha Lynn Pratt, LSW
• Mary Grace Pratt
• Brianna Preble
• Premier Allergy
• Premier Allergy and Asthma Inc
• Premier Wound Care
• Premise Health of Ohio Medical PA
• Premise Health of Ohio Medical, P.a
• Sarah Premo
• Denise Presley

• Family Medicine Physician in Dublin, OH
• Providers in Dublin, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; 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.