Active NPI
Premier Pediatrics, PA
- Pediatric Nurse Practitioner
- Southern Pines, NC
National Provider Identifier
1720226236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 20070048
- Legal business name
- PREMIER PEDIATRICS, PA
- Practice address
- 135 Turner St
Southern Pines, NC 28387-7054 - Phone
- (910) 246-2229
- Fax
- (910) 246-0237
- NPI assigned
- Jan 22, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Petina Ann Sloan
- Title
- Practice Administrator
- Phone
- (910) 246-2229
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 20070048 | NC | Primary |
Addresses
Primary practice location
135 Turner St
Southern Pines, NC 28387-7054
Mailing address
135 Turner St
Southern Pines, NC 28387-7054
Phone (910) 246-2229
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89013C9 | Medicaid | NC |
National Provider Directory
National Provider Directory- Tax ID family
- Premier Pediatrics
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pediatrics Physician
- Southern Pines, NC
- NPI 1588626865
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pediatrics Physician
- Southern Pines, NC
- NPI 1447213053
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232582400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1629676800000",
"number": "1720226236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "135 TURNER ST",
"city": "SOUTHERN PINES",
"state": "NC",
"postal_code": "283877054",
"telephone_number": "910-246-2229",
"fax_number": "910-246-0237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 TURNER ST",
"city": "SOUTHERN PINES",
"state": "NC",
"postal_code": "283877054",
"telephone_number": "910-246-2229",
"fax_number": "910-246-0237"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREMIER PEDIATRICS, PA",
"organizational_subpart": "NO",
"enumeration_date": "2009-01-22",
"last_updated": "2021-08-23",
"certification_date": "2021-08-23",
"status": "A",
"authorized_official_last_name": "SLOAN",
"authorized_official_first_name": "PETINA",
"authorized_official_middle_name": "ANN",
"authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
"authorized_official_telephone_number": "910-246-2229"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NC",
"license": "20070048",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89013C9",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southern Pines, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.