NPIMap

Organization Active NPI

Premier Anesthesia of Washington, PC

  • Anesthesiology Physician
  • Salina, KS
National Provider Identifier
1194617043
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PREMIER ANESTHESIA OF WASHINGTON, PC
Practice address
400 S Santa Fe Ave
Salina, KS 67401-4144
Phone
(678) 690-7812
NPI assigned
Jul 16, 2025
Last updated
Jul 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Authorized official

Name
Randy Walker
Title
VP
Phone
(678) 690-7812

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X NU
Anesthesiology Physician 207L00000X NU Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X NU
Pain Medicine Physician 208VP0000X NU
Interventional Pain Medicine Physician 208VP0014X NU
Pediatric Anesthesiology Physician 207LP3000X NU

Addresses

Primary practice location

400 S Santa Fe Ave
Salina, KS 67401-4144

Mailing address

2655 Northwinds Pkwy
Alpharetta, GA 30009-2280

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250909000453 KS Part B Supplier - Clinic/Group Practice 1153823083 Receives reassigned benefits from 48 practitioners
Practice locations: Salina, KS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1752624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1194617043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 NORTHWINDS PKWY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300092280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S SANTA FE AVE",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674014144",
            "telephone_number": "678-690-7812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ANESTHESIA OF WASHINGTON, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-16",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "678-690-7812"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salina, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.