Organization Active NPI

Premier Health Specialists Inc

  • Surgery Physician
  • Springboro, OH
National Provider Identifier
1629324090
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
PREMIER HEALTH SPECIALISTS INC
Practice address
630 N Main St
Ste 200a
Springboro, OH 45066-7519
Phone
(937) 748-8516
Fax
(937) 748-8732
NPI assigned
Aug 3, 2012
Organization subpart
Yes
Parent organization
PREMIER HEALTH SPECIALISTS INCAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Christopher Danis, MD, MBA
Title
President/Ceo
Phone
(937) 499-8866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050610000010 OH Part B Supplier - Clinic/Group Practice 5597708594 Receives reassigned benefits from 938 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Premier Health Specialist Inc7 organizations share this tax ID, including this one
Part of
Premier Health Specialist Inc

Other organizations with this tax ID 6

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

NPPES NPI Registry

Primary practice location

630 N Main St
Ste 200a
Springboro, OH 45066-7519

Mailing address

630 N Main St
Ste 200a
Springboro, OH 45066-7519
Phone (937) 748-8516

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
0070484MedicaidOH

Other names 1

NPPES NPI Registry
  • Advanced Surgical Partners Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 7, 2013.

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383782400000",
    "number": "1629324090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 N MAIN ST",
            "address_2": "STE 200A",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450667519",
            "telephone_number": "937-748-8516",
            "fax_number": "937-748-8732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N MAIN ST",
            "address_2": "STE 200A",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450667519",
            "telephone_number": "937-748-8516",
            "fax_number": "937-748-8732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HEALTH SPECIALISTS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER HEALTH SPECIALISTS INC",
        "enumeration_date": "2012-08-03",
        "last_updated": "2013-11-07",
        "status": "A",
        "authorized_official_last_name": "DANIS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "937-499-8866",
        "authorized_official_credential": "MD, MBA"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0070484",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Surgical Partners",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springboro, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.