Organization Active NPI

Premiere Health Care Plus PA

  • Internal Medicine Physician
  • High Point, NC
National Provider Identifier
1376574004
Registry record updated Feb 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2002-01294 Issued in NC
Legal business name
PREMIERE HEALTH CARE PLUS PA
Practice address
3750 Admiral Dr Ste 101
High Point, NC 27265-1556
Phone
(336) 841-8500
Fax
(336) 841-3999
NPI assigned
Jul 5, 2006
Organization subpart
Yes
Parent organization
PREMIERE HEALTH CARE PLUS PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 18, 2009

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

Authorized official

Name
Dr. George Osei-Bonsu, M.D.NPI 1083679864
Title
Corporate Officer
Phone
(336) 841-8500

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 2002-01294 NC Primary

Addresses

Primary practice location

3750 Admiral Dr Ste 101
High Point, NC 27265-1556

Mailing address

3750 Admiral Drive
Suite 101
Highpoint, NC 27265-1556
Phone (336) 841-8500

Other identifiers 1

IdentifierTypeStateIssuer
5950538MedicaidNC

Other names 1

  • dba Palladium Primary Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060719000293 NC Part B Supplier - Clinic/Group Practice 1153334099 Receives reassigned benefits from 2 practitioners
Practice locations: High Point, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1078139Palladium Primary Care3750 Admiral Drive, Suite 101, High Point, NC 27265Certificate of waiverFeb 10, 2027

National Provider Directory

National Provider Directory
Part of
Premiere Health Care Plus PA

Practitioners & affiliated clinicians

Practitioners 2

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": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234915200000",
    "number": "1376574004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 ADMIRAL DRIVE",
            "address_2": "SUITE 101",
            "city": "HIGHPOINT",
            "state": "NC",
            "postal_code": "272651556",
            "telephone_number": "336-841-8500",
            "fax_number": "336-841-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 ADMIRAL DR STE 101",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272651556",
            "telephone_number": "336-841-8500",
            "fax_number": "336-841-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE HEALTH CARE PLUS PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIERE HEALTH CARE PLUS PA",
        "enumeration_date": "2006-07-05",
        "last_updated": "2009-02-18",
        "status": "A",
        "authorized_official_last_name": "OSEI-BONSU",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "CORPORATE OFFICER",
        "authorized_official_telephone_number": "336-841-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2002-01294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5950538",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Palladium Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.