Organization Active NPI

Premier Medical LLC

  • Family Medicine Physician
  • Henderson, NV
National Provider Identifier
1306369442
Registry record updated Mar 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11791 Issued in NV
Legal business name
PREMIER MEDICAL LLC
Practice address
3001 Saint Rose Pkwy
Henderson, NV 89052-3839
Phone
(702) 453-3799
Fax
(702) 453-5741
NPI assigned
Jul 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2018

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

Authorized official

Name
Anant K Sonpatki, M.D.NPI 1407877343
Title
Owner / Provider
Phone
(503) 449-8752

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X 11791 NV Primary

Addresses

Primary practice location

3001 Saint Rose Pkwy
Henderson, NV 89052-3839

Mailing address

2660 Crimson Canyon Dr Ste 130
Las Vegas, NV 89128-0846
Phone (702) 453-3799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180416002497 NV Part B Supplier - Clinic/Group Practice 8224391743 Receives reassigned benefits from 6 practitioners
Practice locations: Henderson, NV; Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

102 E Lake Mead Pkwy
Fl 3
Henderson, NV 89015
Phone (702) 784-4300

1285 E Cactus Ave
Las Vegas, NV 89183
Phone (702) 637-9065

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522454400000",
    "number": "1306369442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 CRIMSON CANYON DR STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280846",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 SAINT ROSE PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523839",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-20",
        "last_updated": "2018-03-31",
        "status": "A",
        "authorized_official_last_name": "SONPATKI",
        "authorized_official_first_name": "ANANT",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER / PROVIDER",
        "authorized_official_telephone_number": "503-449-8752",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "11791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2018; 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.

Verify at the official NPI Registry.