Premier Diagnostics LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

PREMIER DIAGNOSTICS LLC

Doing business as

Centennial Neurodiagnostics LLC

Practice address

3838 Oak Lawn Ave Ste 1420
Dallas, TX 75219-4515

Phone

(888) 482-2334

NPI assigned

Jun 20, 2017

Last updated

Sep 2, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenneth Weatherwax

Title

Director

Phone

(469) 646-8663

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Centennial Neurodiagnostics LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Corticare, Inc.

  • Physiological Laboratory
  • Carlsbad, CA
  • NPI 1972922714

  Member Of

  NPD member

Locations

Practitioners 3

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.

• Christopher K. Cheng, M.D.

  • Neurology Physician
  • Arcadia, CA
  • NPI 1700175312
  NPD
• Joshua Todd Mendelson, M.D.

  • Clinical Neurophysiology Physician
  • Fort Myers, FL
  • NPI 1265641070
  NPD
• Vinod Valentine, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • St Petersburg, FL
  • NPI 1154740520
  NPD

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1528588795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 OAK LAWN AVE STE 1420",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194515",
            "telephone_number": "888-482-2334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 OAK LAWN AVE STE 1420",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194515",
            "telephone_number": "888-482-2334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 S Orange Ave Fl 3",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328013394",
            "country_code": "US",
            "telephone_number": "866-329-8177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREMIER DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-20",
        "last_updated": "2025-09-02",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "WEATHERWAX",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "469-646-8663"
    },
    "taxonomies": [
        {
            "code": "246ZE0500X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, EEG",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "204R00000X",
            "taxonomy_group": "",
            "desc": "Electrodiagnostic Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3875247",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104480100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centennial Neurodiagnostics LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Premier Care Services, LLC
• Premier Chiro Med PLLC
• Premier Choice Medical Lab PLLC
• Premier Concierge Spine PLLC
• Premier Diagnostics Laboratory LLC
• Premier Endovascular, PLLC
• Premier Gastroenterology of Texas PA
• Premier Health Clinic PLLC
• Premier Health Home Care
• Premier Health Specialists

• Physiological Laboratory in Dallas, TX
• Providers in Dallas, TX by specialty
• Physiological Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.