PREMIERE PEDIATRICS PLLC
NPI 1124721410
Pediatrics in Longview, TX
About Premiere Pediatrics Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PREMIERE PEDIATRICS PLLC (NPI 1124721410) is a healthcare organization registered as a pediatrics in Longview, Texas and active in the NPI registry since March 2023. The organization holds a CLIA Waiver certificate valid through April 16, 2027 and lists Samantha Jayne Roworth-chaikin, Physician Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Premiere Pediatrics Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Premiere Pediatrics PLLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (5)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 45D2280237
Premier Pediatrics · Longview, TXFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Premiere Pediatrics PLLC's NPI number?
The NPI number for Premiere Pediatrics PLLC is 1124721410. It was assigned to this organization in the NPPES registry on March 24, 2023.
Where is Premiere Pediatrics PLLC located?
Premiere Pediatrics PLLC is located at 1618 Judson Rd, Longview, TX 75601. The listed phone number is (903) 315-3966.
What is Premiere Pediatrics PLLC's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Premiere Pediatrics PLLC enrolled in Medicare?
Yes. Premiere Pediatrics PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Premiere Pediatrics PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Premiere Pediatrics PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (4) and Pediatric Medicine (1). Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Premiere Pediatrics PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 45D2280237) is associated with this NPI, valid through April 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Premiere Pediatrics PLLC accept?
Health plans from Blue Cross and Blue Shield of Texas and WellPoint list Premiere Pediatrics PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Premiere Pediatrics PLLC was last updated on October 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Premiere Pediatrics Pllc · NPI 1124721410
Pediatrics organization in Longview, Texas. Organization record, active in the CMS NPPES registry since March 24, 2023.
## Identity
- **NPI:** 1124721410 (Entity type: Organization)
- **Enumerated:** March 24, 2023
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **Organization subpart:** No
- **Authorized official:** Samantha Roworth-Chaikin, PHYSICIAN OWNER
## Practice location
- **Address:** 1618 JUDSON RD, Longview, TX 75601-3655
- **Phone:** (903) 315-3966 · **Fax:** (903) 230-0795
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (4), Pediatric Medicine (1); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 22, 2026
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1124721410) · Data from the CMS NPPES public registry.