NPIMap

Organization Active NPI

Premise Health of North Carolina Medical, P.C

Doing business as RAI Medical Center

  • General Practice Physician
  • Winston Salem, NC
National Provider Identifier
1619370400
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C
Doing business as
RAI Medical Center
Practice address
401 N Main St
Winston Salem, NC 27101-3804
Phone
(336) 741-5106
NPI assigned
Oct 7, 2014
Last updated
Oct 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Authorized official

Name
Jonathan LeizmanNPI 1447249677
Title
President
Phone
(216) 479-9063

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

401 N Main St
Winston Salem, NC 27101-3804

Mailing address

5500 Maryland Way
Ste 200
Brentwood, TN 37027-4948

Other names 1

  • RAI Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of North Carolina Medical PC14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

401 N Main St
Winston Salem, NC 27101
Phone (336) 245-4571

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1619370400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY",
            "address_2": "STE 200",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N MAIN ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013804",
            "telephone_number": "336-741-5106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-07",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-479-9063"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RAI Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RAI Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.