Premier Physical Electrodiagnostic Medicine,LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

PREMIER PHYSICAL ELECTRODIAGNOSTIC MEDICINE,LLC

Practice address

333 State St
Suite 104
Erie, PA 16507-1450

Phone

(814) 459-0202

Fax

(814) 459-0208

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Theresa A Wheeling, M.D.

Title

President Physician

Phone

(814) 459-0202

Specialties & licenses 1

Addresses

Other names 1

• PPEM Other name

Locations

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811039928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 377",
            "city": "MC KEAN",
            "state": "PA",
            "postal_code": "164260377",
            "telephone_number": "814-459-0202",
            "fax_number": "814-459-0208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 STATE ST",
            "address_2": "SUITE 104",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071450",
            "telephone_number": "814-459-0202",
            "fax_number": "814-459-0208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PHYSICAL ELECTRODIAGNOSTIC MEDICINE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHEELING",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT PHYSICIAN",
        "authorized_official_telephone_number": "814-459-0202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PPEM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Physical Medicine & Rehabilitation Physician in Erie, PA
• Providers in Erie, PA by specialty
• Physical Medicine & Rehabilitation Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.