NPIMap

Organization Active NPI

Premise Health of Ohio Medical, P.a

Doing business as Dollywood Family Healthcare Center

  • Family Medicine Physician
  • Pigeon Forge, TN
National Provider Identifier
1942346275
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PREMISE HEALTH OF OHIO MEDICAL, P.A
Doing business as
Dollywood Family Healthcare Center
Practice address
1022 Dollywood LN
Pigeon Forge, TN 37863-4113
Phone
(865) 908-5322
Fax
(865) 908-9394
NPI assigned
Jan 30, 2007
Last updated
Aug 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Authorized official

Name
Jon Leizman, M.D.
Title
President
Phone
(216) 479-9063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1022 Dollywood LN
Pigeon Forge, TN 37863-4113

Mailing address

5500 Maryland Way
Brentwood, TN 37027-4948
Phone (865) 868-1333

Other names 1

  • Dollywood Family Healthcare Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1942346275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274948",
            "telephone_number": "865-868-1333",
            "fax_number": "865-868-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 DOLLYWOOD LN",
            "city": "PIGEON FORGE",
            "state": "TN",
            "postal_code": "378634113",
            "telephone_number": "865-908-5322",
            "fax_number": "865-908-9394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF OHIO MEDICAL, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-479-9063",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dollywood Family Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dollywood Family Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pigeon Forge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.