Premier Childrens Healthcare PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PREMIER CHILDRENS HEALTHCARE PC

Practice address

1029 West Main St
Suite M
Lebanon, TN 37087

Phone

(615) 453-9492

Fax

(615) 453-9498

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Miss Stacy Kellum

Title

Office Manager

Phone

(615) 453-9492

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270684800000",
    "number": "1851491609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 WEST MAIN ST",
            "address_2": "SUITE M",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "37087",
            "telephone_number": "615-453-9492",
            "fax_number": "615-453-9498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 WEST MAIN ST",
            "address_2": "SUITE M",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "37087",
            "telephone_number": "615-453-9492",
            "fax_number": "615-453-9498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CHILDRENS HEALTHCARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2010-04-08",
        "status": "A",
        "authorized_official_last_name": "KELLUM",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "615-453-9492",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Makayla Posey
• Christine M Potter, APN
• Jennifer Powell, CPHT, CHW, DCCC
• Amy L Powers, APRN
• Rhoda S Powers, ARNP
• Premier Orthopaedics & Sports Medicine, PLC
• Premier Orthopaedics & Sports Medicine, PLC
• Premier Psychiatry
• Premise Health of Tennessee Medical PC
• Diane Gloria Pretorius, PT

• Pediatrics Physician in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; 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.