Active NPI
Premium Healthcare Services, LLC
- Home Health Agency
- Columbus, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- PREMIUM HEALTHCARE SERVICES, LLC
- Practice address
- 2234 S. Hamilton Rd
Ste 101
Columbus, OH 43232-4389 - Phone
- (614) 501-3034
- Fax
- (614) 501-3035
- NPI assigned
- May 4, 2012
- Last updated
- Jul 17, 2026
- 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
- Sigismund V Williams
- Title
- Office Manager
- Phone
- (614) 501-3034
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | NU | Primary |
Addresses
Primary practice location
2234 S. Hamilton Rd
Ste 101
Columbus, OH 43232-4389
Mailing address
2234 S. Hamilton Rd
Ste 101
Columbus, OH 43232-4389
Phone (614) 615-2736
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120625000060 | OH | Part A Provider - Home Health Agency | 2062677131 | Practice locations: Columbus, OH |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1417216920. Details of each certification follow.
Home health agency certification: CCN 368486
- Legal name
- PREMIUM HEALTHCARE SERVICES LLC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Mar 11, 2013
- Last certification
- Jan 16, 2019
- Ownership / control type
- Proprietary
- Organization structure
- LLC
- Enrollment address
- 2234 S Hamilton Rd
Ste 101
Columbus, OH 43232-4300
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Premium Healthcare Services LLC
- Ownership
- Proprietary
- Certified
- Mar 11, 2013
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D2041236 | Premium Healthcare Services, LLC | Certificate of waiver | May 17, 2028 |
National Provider Directory
National Provider DirectoryLocations
2244 S Hamilton Rd
Ste 104
Columbus, OH 43232
Phone (614) 501-3034
Ownership & related parties
All disclosed owners & managing parties 5
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Emerca Jusu-Davies | 5% Or Greater Direct Ownership Interest | Oct 4, 2021 | 100% |
| Henry C James | Corporate Director | Oct 4, 2021 | 100% |
| Ajara Thomas | Corporate Officer | Jul 1, 2017 | 100% |
| Amy Kamara | W-2 Managing Employee | Oct 4, 2021 | 100% |
| Adeola Atanda | W-2 Managing Employee | Apr 30, 2017 | 100% |
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Nurse's Aide
- Canal Winchester, OH
- NPI 1932891876
-
- Home Health Registered Nurse
- Columbus, OH
- NPI 1356546279
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336089600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1784246400000",
"number": "1417216920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2234 S. HAMILTON RD",
"address_2": "STE 101",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432324389",
"telephone_number": "614-615-2736",
"fax_number": "614-501-3035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2234 S. HAMILTON RD",
"address_2": "STE 101",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432324389",
"telephone_number": "614-501-3034",
"fax_number": "614-501-3035"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREMIUM HEALTHCARE SERVICES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-05-04",
"last_updated": "2026-07-17",
"certification_date": "2026-07-17",
"status": "A",
"authorized_official_last_name": "WILLIAMS",
"authorized_official_first_name": "SIGISMUND",
"authorized_official_middle_name": "V",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "614-501-3034"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.