Premier ENT LLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

PREMIER ENT LLC

Practice address

1000 Chinaberry Dr Ste 1103
Bossier City, LA 71111-2463

Phone

(318) 716-1111

Fax

(318) 716-1112

NPI assigned

Dec 8, 2020

Organization subpart

No

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

Authorized official

Name

Debbie Oswalt, CPC

Title

Clinic Manager

Phone

(318) 716-1111

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607990400000",
    "number": "1487250247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CHINABERRY DR STE 1103",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112463",
            "telephone_number": "318-716-1111",
            "fax_number": "318-716-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CHINABERRY DR STE 1103",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112463",
            "telephone_number": "318-716-1111",
            "fax_number": "318-716-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-08",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "OSWALT",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "318-716-1111",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dyshell Poster
• Charles Alfred Powers, MD
• Dave Prakash, MD
• Nealan Dewayne Prather, MD
• Kellandrea Pratt
• Premier ENT LLC
• Premier Medicine LLC
• Premise Health of Louisiana Professional Medical Corporation
• Prep Physical Therapy, LLC
• Bonnie Prescott

• Otolaryngology Physician in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Otolaryngology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.