| Premier Psychiatric Solutions Pllc | |
|
6701 Peters Creek Rd Ste 110 Roanoke VA 24019-4060 | |
| (800) 765-7130 | |
| Not Available |
| Full Name | Premier Psychiatric Solutions Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6701 Peters Creek Rd Ste 110, Roanoke, Virginia |
| Authorized Official Name and Position | Bradley J Goad (OWNER) |
| Authorized Official Contact | 5404882200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Psychiatric Solutions Pllc 6701 Peters Creek Rd Ste 110 Roanoke VA 24019-4060 Ph: (800) 765-7130 | Premier Psychiatric Solutions Pllc 6701 Peters Creek Rd Ste 110 Roanoke VA 24019-4060 Ph: (800) 765-7130 |
| NPI Number | 1053000430 |
|---|---|
| Provider Enumeration Date | 05/02/2023 |
| Last Update Date | 05/17/2023 |
| Certification Date | 05/17/2023 |
| Medicare PECOS PAC ID | 7012373020 |
|---|---|
| Medicare Enrollment ID | O20230517002586 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053000430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Bradley J Goad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285617241 PECOS PAC ID: 1456244391 Enrollment ID: I20040205000124 |
| Provider Name | David B Trinkle |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1598749632 PECOS PAC ID: 6901798412 Enrollment ID: I20040329000949 |
| Provider Name | Kenneth E Fore |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407059637 PECOS PAC ID: 4688798655 Enrollment ID: I20100826001213 |
| Provider Name | Melanie Greer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902237985 PECOS PAC ID: 4082846480 Enrollment ID: I20140918000907 |
| Provider Name | Natasha Ballentine Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992181085 PECOS PAC ID: 8628386554 Enrollment ID: I20150925002691 |
| Provider Name | Michie Armell Bolden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659815736 PECOS PAC ID: 8224313762 Enrollment ID: I20170323000733 |
| Provider Name | Branda Best Hodges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265197388 PECOS PAC ID: 2567854904 Enrollment ID: I20220118000073 |
| Provider Name | Jessica R Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750023875 PECOS PAC ID: 1951798602 Enrollment ID: I20220427000848 |
| Provider Name | Xiaofang Ingram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912604737 PECOS PAC ID: 2961877386 Enrollment ID: I20230417000838 |
| Provider Name | Tanya Chera West |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942072780 PECOS PAC ID: 5193172377 Enrollment ID: I20231109000797 |
| Provider Name | Jennifer Hess Blake |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801574074 PECOS PAC ID: 6901245935 Enrollment ID: I20240423002904 |
| Provider Name | Michelle Page Goodman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508690710 PECOS PAC ID: 5799065702 Enrollment ID: I20241021000326 |
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