Premier Health Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PREMIER HEALTH CLINIC

Practice address

6900 Granger Rd
#203
Independence, OH 44131-1414

Phone

(216) 520-1220

Fax

(216) 520-1222

NPI assigned

Mar 31, 2008

Organization subpart

No

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

Authorized official

Name

John E Kocka

Title

Medical Director

Phone

(216) 520-1220

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206921600000",
    "number": "1467624403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 GRANGER RD",
            "address_2": "#203",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441311414",
            "telephone_number": "216-520-1220",
            "fax_number": "216-520-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 GRANGER RD",
            "address_2": "#203",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441311414",
            "telephone_number": "216-520-1220",
            "fax_number": "216-520-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-31",
        "last_updated": "2008-03-31",
        "status": "A",
        "authorized_official_last_name": "KOCKA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "216-520-1220"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Independence, OH
• Providers in Independence, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; 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.