Organization Active NPI

Premier Health Specialists Inc

  • Clinical Psychologist
  • Franklin, OH
National Provider Identifier
1669668091
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
PREMIER HEALTH SPECIALISTS INC
Practice address
1 Medical Center Drive
Fifth Floor
Franklin, OH 45005-1066
Phone
(513) 420-5233
Fax
(513) 420-8768
NPI assigned
Sep 19, 2007
Organization subpart
Yes
Parent organization
PREMIER HEALTH SPECIALISTS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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

Authorized official

Name
Christopher Danis
Title
President/Ceo
Phone
(937) 499-8866

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

1 Medical Center Drive
Fifth Floor
Franklin, OH 45005-1066

Mailing address

1 Medical Center Drive
Fifth Floor
Franklin, OH 45005-1066
Phone (513) 420-5233

Other identifiers 1

IdentifierTypeStateIssuer
2211510MedicaidOH

Other names 1

  • Anne Camm PsyD Company Doing business as

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
Part of
Premier Health Specialist Inc

Locations

1 Medical Center Dr
Fl Fifth
Middletown, OH 45005
Phone (513) 420-5233

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383782400000",
    "number": "1669668091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DRIVE",
            "address_2": "FIFTH FLOOR",
            "city": "FRANKLIN",
            "state": "OH",
            "postal_code": "450051066",
            "telephone_number": "513-420-5233",
            "fax_number": "513-420-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DRIVE",
            "address_2": "FIFTH FLOOR",
            "city": "FRANKLIN",
            "state": "OH",
            "postal_code": "450051066",
            "telephone_number": "513-420-5233",
            "fax_number": "513-420-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HEALTH SPECIALISTS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER HEALTH SPECIALISTS INC",
        "enumeration_date": "2007-09-19",
        "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"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2211510",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anne Camm PsyD Company",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Franklin, 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.