NPIMap

Organization Active NPI

Premier Personal Health Services, LLC

Doing business as Premier Private Home Care Agency

  • Nursing Care Agency
  • Stone Mountain, GA
National Provider Identifier
1821354630
Registry record updated Apr 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
Legal business name
PREMIER PERSONAL HEALTH SERVICES, LLC
Doing business as
Premier Private Home Care Agency
Practice address
6269 Greenock Dr
Stone Mountain, GA 30087-6081
Phone
(866) 446-4547
Fax
(678) 825-6030
NPI assigned
Apr 5, 2012
Organization subpart
Yes
Parent organization
PREMIER PERSONAL HEALTH SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 5, 2012

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

Authorized official

Name
Mrs. Lisa Yvonne Bradshaw-Small, APRN, BCNPI 1043330301
Title
Ceo
Phone
(866) 447-4547

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X Primary
Community/Behavioral Health Agency 251S00000X
In Home Supportive Care Agency 253Z00000X

Addresses

Primary practice location

6269 Greenock Dr
Stone Mountain, GA 30087-6081

Mailing address

6269 Greenock Dr
Stone Mountain, GA 30087-6081
Phone (866) 446-4547

Other names 1

  • Premier Private Home Care Agency Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Premier Personal Health Services LLC2 organizations share this tax ID, including this one
Part of
Premier Personal Health Services LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333584000000",
    "number": "1821354630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6269 GREENOCK DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300876081",
            "telephone_number": "866-446-4547",
            "fax_number": "678-825-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6269 GREENOCK DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300876081",
            "telephone_number": "866-446-4547",
            "fax_number": "678-825-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PERSONAL HEALTH SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER PERSONAL HEALTH SERVICES, LLC",
        "enumeration_date": "2012-04-05",
        "last_updated": "2012-04-05",
        "status": "A",
        "authorized_official_last_name": "BRADSHAW-SMALL",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "YVONNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "866-447-4547",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN, BC"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Private Home Care Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; 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.