Organization Active NPI

Premier Health & Performance

  • Psychiatry Physician
  • Watkinsville, GA
National Provider Identifier
1699435826
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PREMIER HEALTH & PERFORMANCE
Practice address
3651 Mars Hill Rd Ste 3400
Watkinsville, GA 30677-5985
Phone
(678) 726-2227
NPI assigned
Dec 29, 2021
Last updated
Jan 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Authorized official

Name
Maria Rodriguez-Vargas
Title
Director
Phone
(678) 726-2227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

3651 Mars Hill Rd Ste 3400
Watkinsville, GA 30677-5985

Mailing address

1090 Experiment Station Rd Unit 473
Watkinsville, GA 30677-5375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220422001533 GA Part B Supplier - Clinic/Group Practice 7719374693 Receives reassigned benefits from 7 practitioners
Practice locations: Watkinsville, GA; Toccoa, GA; Savannah, GA; Monroe, GA; Elberton, GA; Athens, GA; Greensboro, GA
O20250220002183 MO Part B Supplier - Clinic/Group Practice 7719374693 Receives reassigned benefits from 1 practitioner
Practice locations: Cape Girardeau, MO; Columbia, MO; Joplin, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2317014Premier Health & Performance3651 Mars Hill Road, Suite 3400, Watkinsville, GA 30677Certificate of waiverJan 15, 2027

National Provider Directory

National Provider Directory

Locations

230 Hospital Dr
Toccoa, GA 30577
Phone (706) 282-4200

1090 Experiment Station Rd
Unit 473
Watkinsville, GA 30677

3651 Mars Hill Rd
Ste 3400
Watkinsville, GA 30677
Phone (706) 502-0503

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1640736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736726400000",
    "number": "1699435826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 EXPERIMENT STATION RD UNIT 473",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306775375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 MARS HILL RD STE 3400",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306775985",
            "telephone_number": "678-726-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HEALTH & PERFORMANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-29",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ-VARGAS",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "678-726-2227"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkinsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.