Active NPI
Permian Premier Health Services Inc
- Contractor
- Odessa, TX
National Provider Identifier
1285664763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 01340161
- Legal business name
- PERMIAN PREMIER HEALTH SERVICES INC
- Practice address
- 520 E 6TH St
Odessa, TX 79761-4527 - Phone
- (615) 467-4474
- Fax
- (615) 467-1267
- NPI assigned
- Jul 3, 2006
- Last updated
- Aug 22, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amy Guay
- Title
- President
- Phone
- (617) 789-5018
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 01340161 | TX | Primary |
Addresses
Primary practice location
520 E 6TH St
Odessa, TX 79761-4527
Mailing address
PO Box 24573
Belfast, ME 04915-4496
Phone (615) 467-4158
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 181766001 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
2501 Jimmy Johnson Blvd
Ste 501B
Port Arthur, TX 77640
Phone (409) 729-2555
1002 Texas Blvd
Ste 400
Texarkana, TX 75501
Phone (903) 434-7071
Practitioners & affiliated clinicians
Practitioners 35
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.
-
- Family Medicine Physician
- Texarkana, AR
- NPI 1922492859
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1629590400000",
"number": "1285664763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 24573",
"city": "BELFAST",
"state": "ME",
"postal_code": "049154496",
"telephone_number": "615-467-4158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 E 6TH ST",
"city": "ODESSA",
"state": "TX",
"postal_code": "797614527",
"telephone_number": "615-467-4474",
"fax_number": "615-467-1267"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PERMIAN PREMIER HEALTH SERVICES INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-03",
"last_updated": "2021-08-22",
"certification_date": "2021-08-22",
"status": "A",
"authorized_official_last_name": "GUAY",
"authorized_official_first_name": "AMY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "617-789-5018"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "TX",
"license": "01340161",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "181766001",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Odessa, TX
- Permian Nephrology Associates PA (Desert Milagro Dialysis Center)
- Permian Orthopaedic Associates
- Permian Pathology Assoc
- Permian Pediatrics PA (Permian Pediatrics)
- Permian Premier Health Services Inc (Steward Medical Group of Texas)
- Permian Pulmonary, P.a.
- Permian Women's Center, P.a
- Colleen Perry, LAT, ATC
- Malathi Latha Perugula, MD
- Scott Cy Peterson, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.