Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jeremy Queen

Individual provider Physician Assistant · NPI 1063132702

Jeremy Queen is a Physician Assistant in Dayton, Ohio. Qualified in 2022, 4 years ago. Practices with Premier Health Specialists Inc, a 575-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
4
Licensed in
OH
In the registry since
2022
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Practice location Address checks out

425 W Grand Ave Ste 3003
Dayton, OH 45405-4722
Phone: (937) 294-3628
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1177469 (OH)

Record details

NPI number1063132702
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 1, 2022
Last updated in NPPESDecember 29, 2022
Certification dateDecember 29, 2022
Mailing address1 Prestige Pl Ste 550, Miamisburg, OH 45342-6115

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Premier Health Specialists Inc — 575 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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