NPIMap

Organization Active NPI

Premier Gastroenterology Associates PLLC

  • Ambulatory Surgical Clinic/Center
  • Little Rock, AR
National Provider Identifier
1073079596
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PREMIER GASTROENTEROLOGY ASSOCIATES PLLC
Practice address
10915 Rodney Parham Rd
Suite a
Little Rock, AR 72212-7221
Phone
(501) 747-2828
Fax
(501) 747-2868
NPI assigned
Feb 20, 2019
Organization subpart
Yes
Parent organization
PREMIER GASTROENTEROLOGY ASSOCIATES PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Todd Greer
Title
Ceo
Phone
(501) 690-4424

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

10915 Rodney Parham Rd
Suite a
Little Rock, AR 72212-7221

Mailing address

PO Box 26618
Little Rock, AR 72221-6601
Phone (501) 313-5200

Other names 1

  • Premier Surgery Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190516001740 AR Part B Supplier - Ambulatory Surgical Center 1153685474 Practice locations: Little Rock, AR

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Premier Gastroenterology Associates Dba Premier Surgery CenterCCN 04C0001098
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2163261Premier Surgery Center10915 N Rodney Parham Rd, Suite a, Little Rock, AR 72212Certificate of waiverMar 10, 2027

National Provider Directory

National Provider Directory
Part of
Premier Gastro Assoc PLLC

Locations

10915 N Rodney Parham Rd
Ste A
Little Rock, AR 72212
Phone (501) 747-2023

1701 Centerview Dr
Ste 312
Little Rock, AR 72211

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 59

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 59

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683072000000",
    "number": "1073079596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26618",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722216601",
            "telephone_number": "501-313-5200",
            "fax_number": "501-747-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10915 RODNEY PARHAM RD",
            "address_2": "SUITE A",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722127221",
            "telephone_number": "501-747-2828",
            "fax_number": "501-747-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER GASTROENTEROLOGY ASSOCIATES PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER GASTROENTEROLOGY ASSOCIATES PLLC",
        "enumeration_date": "2019-02-20",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A",
        "authorized_official_last_name": "GREER",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "501-690-4424",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.