Premier Practitioners, LLC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

NP03335 Issued in OH

Legal business name

PREMIER PRACTITIONERS, LLC

Practice address

22650 Ault Rd
Perrysburg, OH 43551-8953

Phone

(419) 266-5762

Fax

(419) 833-1123

NPI assigned

Jan 12, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Kelly A Shank, NP

Title

Owner

Phone

(419) 266-5762

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jocelyn J Perdeau, CNP

  • Family Nurse Practitioner
  • Maumee, OH
  • NPI 1265417364
  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831240381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22650 AULT RD",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435518953",
            "telephone_number": "419-266-5762",
            "fax_number": "419-833-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22650 AULT RD",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435518953",
            "telephone_number": "419-266-5762",
            "fax_number": "419-833-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PRACTITIONERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHANK",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-266-5762",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "NP03335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2547373",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheila Deborah Post, M.S.W., L.I.S.W.
• Ravi Pothireddy, M.D.
• Nathaniel Potter
• Precision Spinal Care LLC
• Premier Denture Center LLC
• Premiere Counseling Services, LLC
• Prevention Partners of Wood County
• Professional Dental Alliance, LLC (Corner Dental Perrysburg)
• Prohealth Mobile Dental Services Inc
• Prohealth Mobile X-Ray LLC

• Adult Health Nurse Practitioner in Perrysburg, OH
• Providers in Perrysburg, OH by specialty
• Adult Health Nurse Practitioner in Ohio

• 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.