Active NPI
Premier Care of Ohio, LLC
- Methadone Clinic
- Kent, OH
National Provider Identifier
1891404778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Methadone Clinic
- Legal business name
- PREMIER CARE OF OHIO, LLC
- Practice address
- 174 Currie Hall Parkway
Suite a
Kent, OH 44240 - Phone
- (330) 790-5355
- Fax
- (330) 552-3900
- NPI assigned
- Nov 18, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cindy Gaither
- Title
- VP of Revenue Cycle Management
- Phone
- (602) 248-8886
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Community/Behavioral Health Agency | 251S00000X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Methadone Clinic | 261QM2800X | Primary | ||
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X |
Addresses
Primary practice location
174 Currie Hall Parkway
Suite a
Kent, OH 44240
Mailing address
8444 N 90TH St Ste 100
Scottsdale, AZ 85258-4437
Phone (480) 494-2497
Other names 1
- COMMUNITY MEDICAL SERVICES KENT
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Opioid treatment program
- Medicare-enrolled since Jan 1, 2020
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200508000963 | OH | Part B Supplier - Opioid Treatment Program (Otp) | 7719318690 |
17 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Cleveland, OH; Lima, OH; Kettering, OH; Elyria, OH; Columbus, OH; Cincinnati, OH; Akron, OH |
Other NPIs on the same Medicare enrollment 17
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Community/Behavioral Health Agency
- Kettering, OH
- NPI 1003581174
O20200508000963
-
- Community/Behavioral Health Agency
- Cleveland, OH
- NPI 1780337873
O20200508000963
-
- Community/Behavioral Health Agency
- Columbus, OH
- NPI 1851957021
O20200508000963
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668729600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1707436800000",
"number": "1891404778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8444 N 90TH ST STE 100",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852584437",
"telephone_number": "480-494-2497",
"fax_number": "480-687-7361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "174 CURRIE HALL PARKWAY",
"address_2": "SUITE A",
"city": "KENT",
"state": "OH",
"postal_code": "44240",
"telephone_number": "330-790-5355",
"fax_number": "330-552-3900"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREMIER CARE OF OHIO, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-11-18",
"last_updated": "2024-02-09",
"certification_date": "2024-02-09",
"status": "A",
"authorized_official_last_name": "GAITHER",
"authorized_official_first_name": "CINDY",
"authorized_official_title_or_position": "VP OF REVENUE CYCLE MANAGEMENT",
"authorized_official_telephone_number": "602-248-8886"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM2800X",
"taxonomy_group": "",
"desc": "Clinic/Center, Methadone",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QR0405X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "COMMUNITY MEDICAL SERVICES KENT",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "COMMUNITY MEDICAL SERVICES KENT",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Kent, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.