Premier Integrated Healthcare PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

PREMIER INTEGRATED HEALTHCARE PLLC

Practice address

85 W Combs Rd Ste 101-269
San Tan Valley, AZ 85140-9125

Phone

(480) 231-4113

NPI assigned

Apr 5, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Chidozie C Eze, FNP-C

Title

Director

Phone

(480) 231-4113

Specialties & licenses 1

Addresses

Other names 1

• Sozo Medical Group Former legal business name

Locations

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1508445941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 W COMBS RD STE 101-269",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851409125",
            "telephone_number": "480-231-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 W COMBS RD STE 101-269",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851409125",
            "telephone_number": "480-231-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER INTEGRATED HEALTHCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-05",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "EZE",
        "authorized_official_first_name": "CHIDOZIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "480-231-4113",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sozo Medical Group",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Sozo Medical Group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• All providers in San Tan Valley, AZ
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.