NPIMap

Organization Active NPI

Premier Integrated Medical Associates, LTD

  • Clinical Medical Laboratory
  • Dayton, OH
National Provider Identifier
1710944053
Registry record updated Apr 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PREMIER INTEGRATED MEDICAL ASSOCIATES, LTD
Doing business as
PRIMED LABORATORY
Practice address
948 Patterson Rd
Dayton, OH 45419-4336
Phone
(937) 298-7434
Fax
(937) 299-8252
NPI assigned
Apr 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2020

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

Authorized official

Name
Mark Couch, M.D.
Title
President
Phone
(937) 898-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

948 Patterson Rd
Dayton, OH 45419-4336

Mailing address

25 Merchant St Ste 220
Cincinnati, OH 45246-3740
Phone (513) 533-1199

Other identifiers 1

IdentifierTypeStateIssuer
2448788MedicaidOH

Other names 1

  • PRIMED LABORATORY Doing business as

National Provider Directory

National Provider Directory

Locations

948 Patterson Rd
Dayton, OH 45419
Phone (614) 412-1789

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587686400000",
    "number": "1710944053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MERCHANT ST STE 220",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452463740",
            "telephone_number": "513-533-1199",
            "fax_number": "513-645-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "948 PATTERSON RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454194336",
            "telephone_number": "937-298-7434",
            "fax_number": "937-299-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER INTEGRATED MEDICAL ASSOCIATES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A",
        "authorized_official_last_name": "COUCH",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-898-3600",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2448788",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIMED LABORATORY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2020; 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.