NPIMap

Organization Active NPI

Premier Medical Associates, P.C.

Doing business as Premier Medical Associates - North Versailles

  • Non-Pharmacy Dispensing Site
  • North Versailles, PA
National Provider Identifier
1699816967
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
MD022329E Issued in PA
Legal business name
PREMIER MEDICAL ASSOCIATES, P.C.
Doing business as
Premier Medical Associates - North Versailles
Practice address
1916 Lincoln Hwy
North Versailles, PA 15137-2706
Phone
(412) 824-5820
NPI assigned
Feb 9, 2007
Last updated
Oct 16, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDVANTX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Authorized official

Name
Mr. Kenny Heine
Title
Director of Operations
Phone
(858) 625-2990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X MD022329E PA Primary

Addresses

Primary practice location

1916 Lincoln Hwy
North Versailles, PA 15137-2706

Mailing address

5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705
Phone (858) 625-2990

Other names 1

  • Premier Medical Associates - North Versailles Doing business as

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
39D1015314Premier Medical Associates1916 Lincoln Highway, North Versailles, PA 15137Certificate of waiverMar 31, 2028

National Provider Directory

National Provider Directory
Tax ID family
Premier Med Assoc Esma8 organizations share this tax ID, including this one
Part of
Medvantx Inc

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1916 Lincoln Hwy
North Versailles, PA 15137
Phone (412) 824-5820

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350345600000",
    "number": "1699816967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705",
            "telephone_number": "858-625-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 LINCOLN HWY",
            "city": "NORTH VERSAILLES",
            "state": "PA",
            "postal_code": "151372706",
            "telephone_number": "412-824-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL ASSOCIATES, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2007-02-09",
        "last_updated": "2012-10-16",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "PA",
            "license": "MD022329E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Medical Associates - North Versailles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Versailles, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.