NPIMap

Organization Active NPI

Premier Anesthesia of Arizona PC

  • Anesthesiology Physician
  • Goodyear, AZ
National Provider Identifier
1295694610
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PREMIER ANESTHESIA OF ARIZONA PC
Practice address
14200 W Celebrate Life Way
Goodyear, AZ 85338-3007
Phone
(855) 761-0074
NPI assigned
Jan 21, 2026
Last updated
Jan 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X
Anesthesiology Physician 207L00000X Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X
Pain Medicine Physician 208VP0000X
Interventional Pain Medicine Physician 208VP0014X
Pediatric Anesthesiology Physician 207LP3000X

Addresses

Primary practice location

14200 W Celebrate Life Way
Goodyear, AZ 85338-3007

Mailing address

2655 Northwinds Pkwy
Alpharetta, GA 30009-2280
Phone (855) 220-3662

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260319001436 AZ Part B Supplier - Clinic/Group Practice 8224512090 Receives reassigned benefits from 36 practitioners
Practice locations: Goodyear, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 37

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 37

NPI Registry JSON

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

{
    "created_epoch": "1768953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768953600000",
    "number": "1295694610",
    "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",
            "telephone_number": "855-220-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14200 W CELEBRATE LIFE WAY",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853383007",
            "telephone_number": "855-761-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ANESTHESIA OF ARIZONA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-21",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; 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.