NPIMap

Organization Active NPI

Premiere Sports

  • Health Educator
  • Raleigh, NC
National Provider Identifier
1619220431
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
Legal business name
PREMIERE SPORTS
Practice address
2245 Garner Rd
Raleigh, NC 27610-4609
Phone
(919) 270-0821
NPI assigned
Oct 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Authorized official

Name
Dwayne West
Title
Executive Director
Phone
(919) 270-0821

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health EducatorGroup: 193400000X SINGLE SPECIALTY GROUP 174H00000X Primary

Addresses

Primary practice location

2245 Garner Rd
Raleigh, NC 27610-4609

Mailing address

2245 Garner Rd
Raleigh, NC 27610-4609
Phone (919) 270-0821

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1619220431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 GARNER RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276104609",
            "telephone_number": "919-270-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 GARNER RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276104609",
            "telephone_number": "919-270-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE SPORTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-17",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "DWAYNE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-270-0821"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.