Premier Surgical Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PREMIER SURGICAL CENTER, LLC

Practice address

160 Fountains Blvd
Madison, MS 39110

Phone

(601) 968-8132

Fax

(601) 944-9780

NPI assigned

Feb 7, 2018

Organization subpart

No

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

Authorized official

Name

Rebekah Elizabeth Henderson, RN

Title

Or Aministrator

Phone

(601) 391-2525

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Listed as

Premier Surgical Center LLCCCN 25C0001095

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

Practitioners 1

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

• Emile Anthony Picarella Jr., MD

  • Plastic and Reconstructive Surgery Physician
  • Madison, MS
  • NPI 1467663906
  NPD (past)

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

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710201600000",
    "number": "1093214819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 FOUNTAINS BLVD STE C",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106380",
            "telephone_number": "601-391-2525",
            "fax_number": "601-586-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 FOUNTAINS BLVD",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "39110",
            "telephone_number": "601-968-8132",
            "fax_number": "601-944-9780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-07",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "REBEKAH",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OR AMINISTRATOR",
        "authorized_official_telephone_number": "601-391-2525",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Potter, MD
• Madeline Jean Potter, BCBA
• Sylvia L Powell, PT
• Virginia Lea Powell, NP
• Premier Pediatric Healthcare Services
• Michael Preston, LPC
• Rachel Price
• Process Counseling & Wellness
• Bobby E Proctor, M.D.
• Professional Therapy Solutions, LLC

• Ambulatory Surgical Clinic/Center in Madison, MS
• Providers in Madison, MS by specialty
• Ambulatory Surgical Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; 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.