Precision Neuro Diagnostics LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PRECISION NEURO DIAGNOSTICS LLC

Practice address

860654 S 3430 Rd
Chandler, OK 74834-7078

Phone

(979) 248-9890

NPI assigned

Aug 8, 2022

Organization subpart

No

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

Authorized official

Name

Samantha BollichNPI 1215359310

Title

Admin

Phone

(979) 248-9890

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samantha Bollich, CNIM

  • Electroneurodiagnostic Specialist/Technologist
  • Chandler, OK
  • NPI 1215359310
  NPD Authorized official

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1730816869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860654 S 3430 RD",
            "city": "CHANDLER",
            "state": "OK",
            "postal_code": "748347078",
            "telephone_number": "979-248-9890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860654 S 3430 RD",
            "city": "CHANDLER",
            "state": "OK",
            "postal_code": "748347078",
            "telephone_number": "979-248-9890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISION NEURO DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "BOLLICH",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "979-248-9890"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Chandler, OK
• Providers in Chandler, OK by specialty
• Specialist in Oklahoma

• 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.