Premier ER Plus - Waco, LLC

Primary specialty

Emergency Care Clinic/CenterTaxonomy code 261QE0002X

Legal business name

PREMIER ER PLUS - WACO, LLC

Practice address

221 N Jack Kultgen Expy
Suite 100
Waco, TX 76706

Phone

(254) 224-8808

Fax

(254) 224-6590

NPI assigned

Jun 9, 2016

Last updated

Jun 9, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Brenda Pool Davis, RN

Title

Chief Operating Officer

Phone

(254) 224-8808

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871942938. Details of each certification follow.

• CCN 670193 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 670193

Legal name

PREMIER ER

Certification status

Terminated Voluntary: merger or closure, May 11, 2023

Provider type (POS)

Hospital – Short-term

Participating since

Apr 30, 2020

Last certification

Apr 30, 2020

Beds

1

Ownership / control type

Private (not for profit)

Facility address

221 S Jack Kultgen Expressway, Suite 100
Waco, TX 76706

Practitioners 2

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.

• John Bryan Hamilton, MD

  • Emergency Medicine Physician
  • Waco, TX
  • NPI 1972515914
  NPD (past)
• Brittany Morgan Zipperlen, PA-C

  • Physician Assistant
  • Waco, TX
  • NPI 1093165318
  NPD (past)

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465430400000",
    "number": "1871942938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 AUSTIN AVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767011902",
            "telephone_number": "254-224-8808",
            "fax_number": "254-224-6590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 N JACK KULTGEN EXPY",
            "address_2": "SUITE 100",
            "city": "WACO",
            "state": "TX",
            "postal_code": "76706",
            "telephone_number": "254-224-8808",
            "fax_number": "254-224-6590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ER PLUS - WACO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-06-09",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "POOL",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "254-224-8808",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlin Praesel, LPC
• Pranav Loyalka MD PA
• Kristen Pratt, OD
• Sara Elizabeth Prause, SLP
• Venkata Subrahmanya Sastry Prayaga, MD
• Premier House Calls PLLC
• Premier Neurofeedback & Counseling Services, PLLC (Premier Neurofeedback and Counseling Services, PLLC)
• Premise Health of Texas Medical PA (HealthFirst Clinic, Operated by Premise Health)
• Prestige Worldwide Psychiatry
• Barbara D. Price-Toliver

• Emergency Care Clinic/Center in Waco, TX
• Providers in Waco, TX by specialty
• Emergency Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.