NPIMap

Organization Active NPI

Premier Plastic Surgery and Dermatology Associates, LTD

  • Plastic Surgery Physician
  • Centerville, OH
National Provider Identifier
1912345901
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
34005419 Issued in OH
Legal business name
PREMIER PLASTIC SURGERY AND DERMATOLOGY ASSOCIATES, LTD
Practice address
6728 Loop Rd
BLDG. 5, Suite 301
Centerville, OH 45459-2196
Phone
(937) 438-5333
Fax
(937) 438-0160
NPI assigned
Jun 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Authorized official

Name
Dr. Christopher A Reeder, D.O.NPI 1588628820
Title
Owner/Physician
Phone
(937) 438-5333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X 34005419 OH Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

6728 Loop Rd
BLDG. 5, Suite 301
Centerville, OH 45459-2196

Mailing address

6728 Loop Rd
BLDG. 5, Suite 301
Centerville, OH 45459-2196
Phone (937) 438-5333

Other identifiers 1

IdentifierTypeStateIssuer
0847132MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1912345901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6728 LOOP RD",
            "address_2": "BLDG. 5, SUITE 301",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454592196",
            "telephone_number": "937-438-5333",
            "fax_number": "937-438-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6728 LOOP RD",
            "address_2": "BLDG. 5, SUITE 301",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454592196",
            "telephone_number": "937-438-5333",
            "fax_number": "937-438-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PLASTIC SURGERY AND DERMATOLOGY ASSOCIATES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-12",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "REEDER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "937-438-5333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "OH",
            "license": "34005419",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0847132",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.