PREMIER PEDIATRICS PLLC (NPI# 1588121065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588121065 |
| Entity Type | Organization |
| Organization Name | PREMIER PEDIATRICS PLLC |
| Practice Address |
5901 Riley Park Drive Suite B Fort Smith AR 72916 |
| Mailing Address |
5901 Riley Park Drive Suite B Fort Smith AR 72916-9340 |
| Practice Telephone | 4797633050 |
| Practice Fax Number | 4797633281 |
| Mailing Telephone | 4797633050 |
| Mailing Fax Number | 4797633281 |
| Enumeration Date | 2019-02-21 |
| Last Update Date | 2019-07-02 |
| Authorized Official Name | MS. STACI POLLARD (OFFICE MANAGER) |
| Authorized Official Telephone | 4797633050 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | ARKANSAS MEDICAL LICENSE | E-6232 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841814571 | Premier Pediatrics Pllc | Nurse Practitioner | 1700 Nw Gilman Blvd Ste 205, Issaquah, WA 98027-5364 | 2020-05-28 |
| 1881053650 | Premier Pediatrics Pllc | Pediatrics | 900 Lodgeville Rd, Bridgeport, WV 26330-1488 | 2016-02-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PREMIER PEDIATRICS PLLC | 1700 Nw Gilman Blvd Ste 205, Issaquah, WA 98027-5364 |
| Street Address |
5901 RILEY PARK DRIVE SUITE B |
| City | FORT SMITH |
| State | AR |
| Zip Code | 72916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255517066 | Joshua R Wilkinson | Pediatrics | 5901 Riley Park Drive, Suite B, Fort Smith, AR 72916 | 2008-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442506 | Emerald Asher | Massage Therapist | 14522 Us 71, Fort Smith, AR 72916 | 2020-09-22 |
| 1598324220 | Riley Farm Dental & Braces, Pllc | Clinic/Center | 5901 Riley Park Dr., Suite Q, Fort Smith, AR 72916 | 2019-06-06 |
| 1629565072 | Womens Center for Health and Wellness, Pllc | Obstetrics & Gynecology | 8101 Mcclure Dr., Suite 100, Fort Smith, AR 72916 | 2018-04-20 |
| 1750827036 | Angelisa Lambert | Nurse Practitioner | 12300 Old Highway 71 S, Ste A, Fort Smith, AR 72916 | 2017-01-11 |
| 1285946004 | William Justin Hayes Md Pa | Clinic/Center | 920 S. Hwy 45, Bonanza, AR 72916 | 2010-07-09 |
| 1689615445 | Twin Rivers Respiratory Care, Inc. | Durable Medical Equipment & Medical Supplies | 6119 Highway 45, 4, Fort Smith, AR 72916 | 2006-06-10 |
| 1891735098 | William Justin Hayes | Family Medicine | 11300 Roberts Blvd, Chaffee Crossing Clinic, Fort Smith, AR 72916 | 2006-06-07 |
| 1518446491 | Baptist Health Services | Family Medicine | 6100 Massard Rd, Fort Smith, AR 72916 | 2018-08-10 |
| 1184946923 | Ava Knott | Case Manager/Care Coordinator | 1311 Fort Street, Barling, AR 72916 | 2010-02-22 |
| 1508295601 | Andrew S Ryals | Family Medicine | 7003 Chad Colley Blvd, Fort Smith, AR 72916-3000 | 2013-11-08 |
| Find all providers in zip 72916 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255517066 | Joshua R Wilkinson | Pediatrics | 5901 Riley Park Drive, Suite B, Fort Smith, AR 72916 | 2008-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689182412 | Saveritt Pediatrics Pllc | Pediatrics | 5501 Willow Creek Dr Ste 203, Springdale, AR 72762-8708 | 2018-01-15 |
| 1578619177 | John Alonzo Flowers Sr. | Pediatrics | 316 W 5th Ave, Pine Bluff, AR 71601-4214 | 2007-01-26 |
| 1285654285 | William Ladell Douglas | Pediatrics | 100 E 20th St, Suite B, Hope, AR 71801-8213 | 2006-07-20 |
| 1811955974 | Loren Barry Allen | Pediatrics | 1223 W Poplar St, Rogers, AR 72756-4245 | 2006-05-01 |
| 1093779787 | Lloyene Bruce-reid | Pediatrics | 1420 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2006-04-12 |
| 1972502953 | Floyd Gonzalez | Pediatrics | 821 Walter J Leeper Dr, Suite 101, De Queen, AR 71832-2591 | 2005-07-20 |
| 1700885522 | Renee Jones | Pediatrics | 615 N Main St, Brinkley, AR 72021-2507 | 2005-07-14 |
| 1881162469 | Jefferson Hospital Association, Inc. | Pediatrics | 1420 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2018-11-13 |
| 1366767972 | Michael Israel | Pediatrics | 1 Childrens Way, Slot 512-19a, Little Rock, AR 72202-3500 | 2010-04-07 |
| 1164604930 | Flowers Pediatraic Clinic | Pediatrics | 316 W 5th Ave, Pine Bluff, AR 71601-4214 | 2007-12-03 |
| Find all providers with the same taxonomy | ||||
| City | FORT SMITH |
| Zip Code | 72916 |
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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.