NPIMap

Organization Active NPI

Premise Health of Ohio Medical, P.a

  • Occupational Medicine Clinic/Center
  • Everett, WA
National Provider Identifier
1366884504
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X
Legal business name
PREMISE HEALTH OF OHIO MEDICAL, P.A
Doing business as
Everett Occupational Health Center
Practice address
1200 Merrill Creek Pkwy
Everett, WA 98203-7152
Phone
(425) 407-6431
Fax
(425) 407-6566
NPI assigned
Jul 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Authorized official

Name
Jon Leizman, M.D.
Title
President
Phone
(216) 479-9063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Clinic/Center 261QX0100X Primary

Addresses

Primary practice location

1200 Merrill Creek Pkwy
Everett, WA 98203-7152

Mailing address

5500 Maryland Way
Brentwood, TN 37027-4948
Phone (877) 865-9013

Other names 1

  • Everett Occupational Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of Ohio Medical PA45 organizations share this tax ID, including this one

Other organizations with this tax ID 44

Organizations that report the same tax identification number in the National Provider Directory.

View all 44

Locations

1200 Merrill Creek Pkwy
Everett, WA 98203
Phone (425) 407-6431

NPI Registry JSON

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1366884504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274948",
            "telephone_number": "877-865-9013",
            "fax_number": "217-709-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MERRILL CREEK PKWY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982037152",
            "telephone_number": "425-407-6431",
            "fax_number": "425-407-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF OHIO MEDICAL, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-29",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-479-9063",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Everett Occupational Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Everett Occupational Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.