Premier Health LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

PREMIER HEALTH LLC

Practice address

13 Town West Rd Ste B-3
Plymouth, NH 03264-3428

Phone

(603) 945-8048

Fax

(603) 945-7110

NPI assigned

Jul 24, 2018

Organization subpart

No

Name

Mariya KoganNPI 1093061772

Title

Ceo

Phone

(917) 566-5997

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

• Wendy Elizabeth Bayless, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Plymouth, NH
  • NPI 1700514395

  NH

  Medicare reassignment Care Compare group NPD
• Richard Nasstrom, D.O.

  • Psychiatry Physician
  • Plymouth, NH
  • NPI 1144665712

  NH, Psychiatry

  Medicare reassignment Care Compare group NPD
• Mariya Kogan, APRN

  • Certified Registered Nurse Anesthetist
  • Littleton, NH
  • NPI 1093061772

  Nurse Anesthetist, Certified Registered

  NPD Authorized official
• Lydia Anne McKenzie, DNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Plymouth, NH
  • NPI 1386129856
  NPD

Medicare fee-for-service enrollment

Enrolled in NH

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 14, 2023.

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699920000000",
    "number": "1760969679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 MAIN ST STE 6C",
            "city": "FRANCONIA",
            "state": "NH",
            "postal_code": "035804835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 TOWN WEST RD STE B-3",
            "city": "PLYMOUTH",
            "state": "NH",
            "postal_code": "032643428",
            "telephone_number": "603-945-8048",
            "fax_number": "603-945-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-24",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A",
        "authorized_official_last_name": "KOGAN",
        "authorized_official_first_name": "MARIYA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "917-566-5997"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Plymouth General Dentistry, PLLC
• Plymouth Optical
• Plymouth School District
• Barbara Ann Pope
• Bridget Powers, MS, CCC-SLP
• Janice Quintal, PHD
• Hayley Quirk
• Alexandria Sarah Raifsnider
• Bethany Ralph
• Megan E Rebele

• All providers in Plymouth, NH
• Psychiatry Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.