PREMIER PHYSICIANS CENTERS, INC (NPI# 1396928883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396928883 |
| Entity Type | Organization |
| Organization Name | PREMIER PHYSICIANS CENTERS, INC |
| Practice Address |
15644 Madison Ave Suite 218 Lakewood OH 44107-5622 |
| Mailing Address |
20525 Center Ridge Rd Suite 220 Rocky River OH 44116-3437 |
| Practice Telephone | 2162279839 |
| Practice Fax Number | 2162279867 |
| Mailing Telephone | 4408955056 |
| Mailing Fax Number | 4403332935 |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2010-06-09 |
| Authorized Official Name | MR. DICK FINTZ (CFO) |
| Authorized Official Telephone | 4408955056 |
| Is Organization Subpart | Y |
| Parent Organization Name | PREMIER PHYSICIANS CENTERS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GROUP ASC | 3610861 | 01 | |
| GROUP RR MEDICARE | CA4511 | 01 | |
| GROUP NPI | 1396928883 | 01 | |
| RAILROAD MEDICARE GROUP # | 220004287 | 01 | |
| GROUP LAB MEDICARE # | D368301 | 01 | |
| GROUP MEDICAID | 0119204 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942483433 | Premier Physicians Centers, Inc | Clinic/Center | 25200 Center Ridge Rd, Suite 3100, Westlake, OH 44145-4141 | 2007-12-07 |
| Street Address |
15644 MADISON AVE SUITE 218 |
| City | LAKEWOOD |
| State | OH |
| Zip Code | 44107-5622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679574156 | West Side Cardiothoracic Surgeons, Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 15644 Madison Ave, Suite #202, Lakewood, OH 44107-5622 | 2005-08-09 |
| 1215311931 | Sara Perry | Chiropractor | 15644 Madison Ave, Ste 213, Lakewood, OH 44107-5622 | 2015-07-13 |
| 1770962565 | Royalty Care Services LLC | Hospice Care, Community Based | 15644 Madison Ave, Ste 207, Lakewood, OH 44107-5622 | 2015-05-26 |
| 1205245669 | Donna Rakerd | Social Worker | 15644 Madison Ave, Lakewood, OH 44107-5622 | 2014-08-10 |
| 1104240019 | Premier Physicians Centers, Inc. | Durable Medical Equipment & Medical Supplies | 15644 Madison Ave, Suite 213, Lakewood, OH 44107-5622 | 2014-02-12 |
| 1538334545 | Outreach Professional Services, Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 15644 Madison Ave, Suite 202, Lakewood, OH 44107-5622 | 2008-04-30 |
| 1053591321 | Dr. Mark S. Massie, L.L.C. | Podiatrist | 15644 Madison Ave, Lakewood, OH 44107-5622 | 2007-11-05 |
| 1053509869 | Enrique Cotes | Pathology | 15644 Madison Ave, Suite 218, Lakewood, OH 44107-5622 | 2007-10-05 |
| 1629149307 | Cynthia Ann Walsh | Social Worker | 15644 Madison Ave, Suite 108, Lakewood, OH 44107-5622 | 2006-11-13 |
| 1992801658 | The Foot and Ankle Clinic LLC | Podiatrist | 15644 Madison Ave, 213, Lakewood, OH 44107-5622 | 2006-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326522210 | Lawrence M Roth | Social Worker | 14701 Detroit Ave Ste 363, Lakewood, OH 44107 | 2018-09-18 |
| 1376065730 | Fareeha Khan | Internal Medicine | 12540 Edgewater Drive, Apt 411, Lakewood, OH 44107 | 2017-07-07 |
| 1912433756 | Julie Ann Foucher-urcuyo | Family Medicine | 14601 Detroit Ave, Fl 2, Lakewood, OH 44107 | 2017-05-11 |
| 1225563661 | Elizabeth Ann Rainbolt | Family Medicine | 14601 Detroit Ave Fl 2, Lakewood, OH 44107 | 2017-04-24 |
| 1255882551 | Kristen Murray | Dietitian, Registered | 14900 Detroit Ave Ste 207, Lakewood, OH 44107 | 2016-10-21 |
| 1265828131 | David Thomas Jonke | Dentist | 15640 Madison Ave., Lakewood, OH 44107 | 2015-04-08 |
| 1760885941 | Debra Watkins | Home Health Aide | 1510 Newman Ave Apt 406, Lakewood, OH 44107 | 2014-10-02 |
| 1396155198 | Monica M Owen | Occupational Therapist | 9200 Biddulph Rd., Brooklyn, OH 44107 | 2014-05-01 |
| 1730512229 | Marsha Elaine Favors | Licensed Practical Nurse | 1448 Lakeland Ave, Lakewood, OH 44107 | 2013-08-20 |
| 1508130006 | Ruth Rachel Raciniewski | Counselor | 15200 Madison Avenue, Lakewood, OH 44107 | 2012-03-01 |
| Find all providers in zip 44107 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
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| 1528418936 | Laboratory Corporation of America | Clinical Medical Laboratory | 7424 Bridgeport Way W, Suite 201, Lakewood, WA 98499-8120 | 2016-06-16 |
| 1770910879 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 1771 Madison Ave, Lakewood, NJ 08701-1242 | 2013-10-03 |
| 1720352974 | Kaiser Foundation Health Plan of Colorado | Clinical Medical Laboratory | 8383 W Alameda Ave, Lakewood, CO 80226-3007 | 2012-03-06 |
| 1669792834 | Laboratory Corporation of America | Clinical Medical Laboratory | 165 S Union Blvd, Ste 800, Lakewood, CO 80228-2215 | 2010-06-10 |
| 1710216650 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 5920 100th St Sw, Ste 29, Lakewood, WA 98499-2751 | 2009-12-23 |
| 1417190034 | Dry Creek Imaging, LLC | Clinical Medical Laboratory | 14062 Denver West Pkwy, Ste. 180 Bldg 52, Lakewood, CO 80401-3187 | 2009-04-13 |
| Find all providers in LAKEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.