Premier Orthopaedic and Sports Medicine Associates LTD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES LTD

Practice address

455 Woodview Rd Ste 205
West Grove, PA 19390-9315

Phone

(484) 748-6148

Fax

(610) 869-2320

NPI assigned

Jun 10, 2019

Organization subpart

Yes

Parent organization

PREMIER ORTHOPAEDIC & SPORTS MEDICINE ASSO., LTD.As reported in NPPES

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

Authorized official

Name

Heather Defazio

Title

Executive Assistant

Phone

(610) 692-6280

Specialties & licenses 8

Addresses

Part of

Premier Orthopaedics SP

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Premier Orthopaedic & Sports Medicine Asso., LTD.

  • Durable Medical Equipment & Medical Supplies
  • Philadelphia, PA
  • NPI 1619556008
  NPPES parent name

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560124800000",
    "number": "1508425992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 OLD FERN HILL ROAD",
            "address_2": "BLDG A STE 1",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193804269",
            "telephone_number": "610-692-6280",
            "fax_number": "610-429-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 WOODVIEW RD STE 205",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193909315",
            "telephone_number": "484-748-6148",
            "fax_number": "610-869-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER ORTHOPAEDIC & SPORTS MEDICINE ASSO., LTD.",
        "enumeration_date": "2019-06-10",
        "last_updated": "2019-06-10",
        "status": "A",
        "authorized_official_last_name": "DEFAZIO",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "610-692-6280"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Physiotherapy Associates Inc
• Nicole Lynn Pickrell
• Debra Pisarcik, D.M.D.
• Richard Ivan Plotzker, MD
• Premier Dental
• Premier Orthopaedic and Sports Medicine Associates, LTD
• Ramesht LLC
• Razaullah a. Khwaja, M.D.
• Ysan Miller Reischke, P.T.
• Renal Treatment Centers Northeast Inc

• Orthopaedic Surgery Physician in West Grove, PA
• Providers in West Grove, PA by specialty
• Orthopaedic Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; 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.