Active NPI
Premier Health Specialists Inc
- Pediatric Cardiology Physician
- Kettering, OH
National Provider Identifier
1891932604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Cardiology Physician
- Legal business name
- PREMIER HEALTH SPECIALISTS INC
- Practice address
- 5450 Far Hills Ave
Suite 124
Kettering, OH 45429-2386 - Phone
- (937) 435-2920
- NPI assigned
- Jan 15, 2009
- Organization subpart
- Yes
- Parent organization
- PREMIER HEALTH SPECIALISTS INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Christopher Danis, MD
- Title
- President/Ceo
- Phone
- (937) 435-4263
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Cardiology Physician | 2080P0202X | Primary |
Addresses
Primary practice location
5450 Far Hills Ave
Suite 124
Kettering, OH 45429-2386
Mailing address
5450 Far Hills Ave
Suite 124
Kettering, OH 45429-2386
Phone (937) 435-2920
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2951186 | Medicaid | OH |
Other names 1
- Pediatric Cardiology of Dayton
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050610000010 | OH | Part B Supplier - Clinic/Group Practice | 5597708594 |
Receives reassigned benefits from 938 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Part of
- Premier Health Specialist Inc
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231977600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1383782400000",
"number": "1891932604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5450 FAR HILLS AVE",
"address_2": "SUITE 124",
"city": "KETTERING",
"state": "OH",
"postal_code": "454292386",
"telephone_number": "937-435-2920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5450 FAR HILLS AVE",
"address_2": "SUITE 124",
"city": "KETTERING",
"state": "OH",
"postal_code": "454292386",
"telephone_number": "937-435-2920"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREMIER HEALTH SPECIALISTS INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PREMIER HEALTH SPECIALISTS INC",
"enumeration_date": "2009-01-15",
"last_updated": "2013-11-07",
"status": "A",
"authorized_official_last_name": "DANIS",
"authorized_official_first_name": "CHRISTOPHER",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "937-435-4263",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2080P0202X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics, Pediatric Cardiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2951186",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Pediatric Cardiology of Dayton",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Kettering, OH
- Premier Care of Ohio LLC
- Premier Care of Ohio LLC
- Premier Care of Ohio LLC
- Premier Care of Ohio LLC
- Premier Health Specialists Inc
- Premier Integrated Medical Assoc LTD
- Premier Integrated Medical Assoc LTD
- Premier Integrated Medical Assoc LTD
- Premier Integrated Medical Assoc LTD
- Premier Integrated Medical Assoc LTD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; 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.