Premise Health of Oklahoma Medical, P.C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PREMISE HEALTH OF OKLAHOMA MEDICAL, P.C

Doing business as

Employees' Healthcare Center of Stillwater

Practice address

406 E Hall of Fame Ave
Stillwater, OK 74075-5428

Phone

(800) 370-1192

Fax

(405) 707-3015

NPI assigned

Dec 21, 2006

Organization subpart

No

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

Authorized official

Name

Jonathan Leizman, M.D.NPI 1447249677

Title

PC Owner

Phone

(216) 479-9063

Specialties & licenses 1

Addresses

Other names 1

• Employees' Healthcare Center of Stillwater Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Premise Health of Oklahoma Medical PC

  dba Michelin Family Heatlh Center-Ardmore

  • Clinic/Center
  • Ardmore, OK
  • NPI 1740540327

  O20050322000100

  Same enrollment
• Premise Health of Oklahoma Medical PC

  dba the Doc Powered by Premise Health

  • Multi-Specialty Clinic/Center
  • Oklahoma City, OK
  • NPI 1902475957

  O20050322000100

  Same enrollment
• Premise Health of Oklahoma Medical, P.C

  dba Goodyear Family Medical Center

  • Family Medicine Physician
  • Lawton, OK
  • NPI 1841360336

  O20050322000100

  Same enrollment

Practitioners 1

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.

• Jonathan B Leizman, M.D.

  • Family Medicine Physician
  • Pepper Pike, OH
  • NPI 1447249677
  Authorized official Same address or phone

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1427112648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BURTON HILLS BLVD",
            "address_2": "SUITE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156155",
            "telephone_number": "615-565-1733",
            "fax_number": "615-296-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 E HALL OF FAME AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740755428",
            "telephone_number": "800-370-1192",
            "fax_number": "405-707-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF OKLAHOMA MEDICAL, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PC OWNER",
        "authorized_official_telephone_number": "216-479-9063",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Employees' Healthcare Center of Stillwater",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Employees' Healthcare Center of Stillwater",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Abigail Poulan, DDS
• Hannah Pouliot
• Porsha Prater
• Brittany Anne Pratt, PT, DPT
• Preferred Family Healthcare, Inc. (Dayspring Community Services)
• Sophia Elizabeth Price
• Charlena Priddy, MS
• Madelyn Priest, MS, CCC-SLP
• Sydney Pruett, MCP, LPC
• Christopher Allen Puckett, M.D.

• Family Medicine Physician in Stillwater, OK
• Providers in Stillwater, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.