Premier Professional Surgery Center PC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PREMIER PROFESSIONAL SURGERY CENTER PC

Practice address

5014 Villa Linde Pkwy
Flint, MI 48532-3411

Phone

(810) 733-5450

Fax

(810) 733-8130

NPI assigned

Jan 29, 2006

Organization subpart

No

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

Authorized official

Name

Heather Laffrey

Title

Manager

Phone

(810) 733-5450

Specialties & licenses 1

Addresses

Other names 1

• Parkeye surgi center Former legal business name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Ambulatory surgical center certification: CCN 23C0001015

Legal name

PREMIER PROFESSIONAL SURGERY CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Oct 13, 1987

Last certification

Sep 2, 1999

Ownership / control type

Proprietary

Facility address

5014 Villa Linde Parkway
Flint, MI 48532

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

CLIA laboratory certificates

Practitioners 3

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

• Aman Khaled Shukairy, MD

  • Ophthalmology Physician
  • Flint, MI
  • NPI 1205046331
  NPD
• Khaled M Shukairy, M.D.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Burton, MI
  • NPI 1518961879
  NPD
• Mohammad Kareem Shukairy, MD

  • Otolaryngology Physician
  • Burton, MI
  • NPI 1497319347

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1138492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595376000000",
    "number": "1528039567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5014 VILLA LINDE PKWY",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323411",
            "telephone_number": "810-733-5450",
            "fax_number": "810-733-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5014 VILLA LINDE PKWY",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323411",
            "telephone_number": "810-733-5450",
            "fax_number": "810-733-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PROFESSIONAL SURGERY CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-29",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A",
        "authorized_official_last_name": "LAFFREY",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "810-733-5450"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkeye surgi center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Premier Head and Neck Surgery PC
• Premier Medical Clinics PC
• Premier RX Pharmacy LLC
• Premier Thinking Mental Health Services, LLC
• Candace Elizabeth Prentice
• Clayton Travis Prescott
• Tiesha U Presnall

• Ambulatory Surgical Clinic/Center in Flint, MI
• Providers in Flint, MI by specialty
• Ambulatory Surgical Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.