NPIMap

Organization Active NPI

Premier Credentialing LLC

  • Contractor
  • Pottsboro, TX
National Provider Identifier
1689302283
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Legal business name
PREMIER CREDENTIALING LLC
Practice address
267 Hidden Oaks TRL
Pottsboro, TX 75076-4109
Phone
(469) 474-9575
Fax
(877) 303-4532
NPI assigned
Aug 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Authorized official

Name
Roma RobinsonNPI 1518695642
Title
Owner
Phone
(469) 474-9575

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ContractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171W00000X Primary

Addresses

Primary practice location

267 Hidden Oaks TRL
Pottsboro, TX 75076-4109

Mailing address

267 Hidden Oaks TRL
Pottsboro, TX 75076-4109
Phone (469) 474-9575

Other names 1

  • Premier Credentialing LLC Other name

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL N/A Direct
CONNECT URL N/A Direct

National Provider Directory

National Provider Directory

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": "1660176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1689302283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 HIDDEN OAKS TRL",
            "city": "POTTSBORO",
            "state": "TX",
            "postal_code": "750764109",
            "telephone_number": "469-474-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 HIDDEN OAKS TRL",
            "city": "POTTSBORO",
            "state": "TX",
            "postal_code": "750764109",
            "telephone_number": "469-474-9575",
            "fax_number": "877-303-4532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CREDENTIALING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-11",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-05",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "ROMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-474-9575"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "267 Hidden Oaks Trl",
            "city": "Pottsboro",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750764109",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "267 Hidden Oaks Trl",
            "city": "Pottsboro",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750764109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Premier Credentialing LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pottsboro, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.