Premier Sports Medicine, Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

PREMIER SPORTS MEDICINE, INC.

Practice address

35670 Kenai Spur Hwy Ste 104
Soldotna, AK 99669-7649

Phone

(907) 262-0801

Fax

(907) 262-0860

NPI assigned

Oct 10, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Cheryl Kay Larson

Title

Owner/Office Manager

Phone

(907) 262-0801

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian Edward Larson, DC

  • Chiropractor
  • Soldotna, AK
  • NPI 1952473415
  Medicare reassignment Care Compare group NPD
• Ian Ques, DPT

  • Physical Therapist
  • Shallotte, NC
  • NPI 1346934452

  AK

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539129600000",
    "number": "1659846293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35670 KENAI SPUR HWY STE 104",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697649",
            "telephone_number": "907-262-0801",
            "fax_number": "907-262-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35670 KENAI SPUR HWY STE 104",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697649",
            "telephone_number": "907-262-0801",
            "fax_number": "907-262-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SPORTS MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-10",
        "last_updated": "2018-10-10",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OWNER/OFFICE MANAGER",
        "authorized_official_telephone_number": "907-262-0801",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin J Pontius, D.C, M.S
• Justin D Poulson, DMD
• Kathleen Powell, O.D.
• Kimberly D. Powell
• Precision Chiropractic LLC
• Crystal M Prescott
• Makayla R Prescott
• Linda Kay Price, R.N.
• Heather Pritchard, LMT
• Robin L Probart

• General Practice Physician in Soldotna, AK
• Providers in Soldotna, AK by specialty
• General Practice Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; 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.