Active NPI
Premier Health Specialists Inc
- Surgery Physician
- Springboro, OH
National Provider Identifier
1629324090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- 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 INC
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 Inc
- 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.
-
- Durable Medical Equipment & Medical Supplies
- Dayton, OH
- NPI 1023556420
-
- Cardiovascular Disease Physician
- Middletown, OH
- NPI 1629212279
-
- Podiatrist
- Miamisburg, OH
- NPI 1740528843
-
- Durable Medical Equipment & Medical Supplies
- Dayton, OH
- NPI 1770022170
-
- Foot & Ankle Surgery Podiatrist
- Dayton, OH
- NPI 1902211287
-
- General Acute Care Hospital
- Oakwood, OH
- NPI 1952853483
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | Primary |
Addresses
NPPES NPI RegistryPrimary 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| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0070484 | Medicaid | OH |
Other names 1
NPPES NPI Registry- Advanced Surgical Partners
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.