Healthcare Provider Details

I. General information

NPI: 1467711523
Provider Name (Legal Business Name): PREMISE HEALTH OF NORTH CAROLINA MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2012
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9377 N US HIGHWAY 301 # 670
WHITAKERS NC
27891-8621
US

IV. Provider business mailing address

5500 MARYLAND WAY STE 120
BRENTWOOD TN
37027-4993
US

V. Phone/Fax

Practice location:
  • Phone: 252-437-9211
  • Fax: 252-437-9774
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEVEN ASHLEY HINITT
Title or Position: PRESIDENT
Credential:
Phone: 844-407-7557