Organization Active NPI

Premium Healthcare Services, LLC

  • Home Health Agency
  • Columbus, OH
National Provider Identifier
1417216920
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
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, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Authorized official

Name
Sigismund V WilliamsNPI 1932891876
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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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
LLCProprietary
Enrollment address
2234 S Hamilton Rd
Ste 101
Columbus, OH 43232-4300
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Premium Healthcare Services LLCCCN 368486 · All quality measures
Ownership
Proprietary
Certified
Mar 11, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
36D2041236Premium Healthcare Services, LLC2234 S Hamilton Rd, Suite 101, Columbus, OH 43232Certificate of waiverMay 17, 2028

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
Emerca Jusu-Davies Individual 5% Or Greater Direct Ownership Interest Oct 4, 2021 100%
Henry C James Individual Corporate DirectorAsst. Admin Oct 4, 2021 100%
Ajara Thomas Individual Corporate OfficerAdministrator Jul 1, 2017 100%
Amy Kamara Individual W-2 Managing EmployeeDirector of Clinical Services Oct 4, 2021 100%
Adeola Atanda Individual W-2 Managing EmployeeDir of Clinical Services 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.

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

Verify at the official NPI Registry.