PREMIER PEDIATRICS PLLC NPI 1588121065

NPI Information

  • NPI: 1588121065
  • Provider Name: PREMIER PEDIATRICS PLLC
  • Classification: Pediatrics - 2080A0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Organization
  • CLIA Number: 04D2166063
  • Address: 5901 RILEY PARK DRIVE
    SUITE B
    FORT SMITH, AR
    ZIP 72916
  • Phone: (479) 763-3050

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NPI Details

PREMIER PEDIATRICS PLLC is an adolescent medicine pediatrics in Fort Smith, AR. The provider is 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. PREMIER PEDIATRICS PLLC NPI is 1588121065. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5901 RILEY PARK DRIVE
SUITE B
FORT SMITH, AR
ZIP 72916
Phone: (479) 763-3050
Fax: (479) 763-3281

The provider's authorized official is Staci Pollard .
The authorized official title is Office Manager and has the following contact phone number (479) 763-3050.

The CLIA number assigned to this NPI record is 04D2166063 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/21/2019 and was last updated on 7/2/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080A0000XPediatricsAdolescent MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1E-6232OTHERARKANSASARKANSAS MEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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