NPIMap

Organization Active NPI

Premise Health of North Carolina Medical, P.C

Doing business as Smithfield Family Medical Center

  • Family Medicine Physician
  • Tar Heel, NC
National Provider Identifier
1467516534
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C
Doing business as
Smithfield Family Medical Center
Practice address
16526 NC Highway 87 W
Tar Heel, NC 28392-8608
Phone
(910) 872-5720
Fax
(910) 872-5739
NPI assigned
Dec 21, 2006
Last updated
Aug 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

16526 NC Highway 87 W
Tar Heel, NC 28392-8608

Mailing address

5500 Maryland Way Ste 120
Brentwood, TN 37027-4993
Phone (216) 479-9063

Other names 1

  • Smithfield Family Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of North Carolina Medical PC54 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1467516534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY STE 120",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274993",
            "telephone_number": "216-479-9063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16526 NC HIGHWAY 87 W",
            "city": "TAR HEEL",
            "state": "NC",
            "postal_code": "283928608",
            "telephone_number": "910-872-5720",
            "fax_number": "910-872-5739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smithfield Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Smithfield Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tar Heel, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.