Premier Pediatrics of Indiana LLC
NPI 1760084156ActiveOrganization· Pediatrics· Granger, IN
Pediatrics in Granger, Indiana, registered in NPPES in November 2020. The authorized official on file is Charisse Johnson, MD, Sole Proprietor. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1760084156 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 11, 2020 |
| Last updated in NPPES | Jul 20, 2021 |
| Certified by provider | Jul 20, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatrics Primary | 208000000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IN) |
|---|
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