NPIMap

Organization Active NPI

Premise Health of Ohio Medical, P.a

  • Occupational Medicine Clinic/Center
  • Napoleon, OH
National Provider Identifier
1396176038
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
Practice address
12-773 State Rout 110
Napoleon, OH 43545-5898
Phone
(419) 599-6787
Fax
(419) 599-6822
NPI assigned
Dec 5, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Occupational Medicine Clinic/Center 261QX0100X Primary

Addresses

Primary practice location

12-773 State Rout 110
Napoleon, OH 43545-5898

Mailing address

5500 Maryland Way
Brentwood, TN 37027-4948
Phone (419) 599-6787

Other names 1

  • Campbell's Soup Napoleon 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

12773 State Route 110
Napoleon, OH 43545
Phone (419) 599-6787

NPI Registry JSON

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

{
    "created_epoch": "1386201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1396176038",
    "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": "419-599-6787",
            "fax_number": "419-599-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12-773 STATE ROUT 110",
            "city": "NAPOLEON",
            "state": "OH",
            "postal_code": "435455898",
            "telephone_number": "419-599-6787",
            "fax_number": "419-599-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF OHIO MEDICAL, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-05",
        "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": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Campbell's Soup Napoleon Occupational Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Campbell's Soup Napoleon Occupational Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Napoleon, OH

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.