NPIMap

Organization Active NPI

Premier Surgical Associates, PLLC

  • Surgery Physician
  • Knoxville, TN
National Provider Identifier
1750449443
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
PREMIER SURGICAL ASSOCIATES, PLLC
Practice address
6408 Papermill Dr
Suite 220
Knoxville, TN 37919-4858
Phone
(865) 306-5675
Fax
(865) 584-7712
NPI assigned
Dec 5, 2006
Last updated
Jul 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Authorized official

Name
Jerome Rom
Title
Ceo
Phone
(865) 306-5675

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary
Plastic and Reconstructive Surgery Physician 2086S0122X NU
Vascular Surgery Physician 2086S0129X NU
Surgical Oncology Physician 2086X0206X NU
Colon & Rectal Surgery Physician 208C00000X NU
Foot & Ankle Surgery Podiatrist 213ES0103X NU

Addresses

Primary practice location

6408 Papermill Dr
Suite 220
Knoxville, TN 37919-4858

Mailing address

PO Box 52948
Knoxville, TN 37950-2948
Phone (865) 306-5675

Other identifiers 1

IdentifierTypeStateIssuer
3707870MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040205000066 TN Part B Supplier - Clinic/Group Practice 1254224181 Receives reassigned benefits from 65 practitioners
Practice locations: Knoxville, TN; Lenoir City, TN; Maryville, TN; Morristown, TN; Oak Ridge, TN; Powell, TN; Sevierville, TN; Chattanooga, TN…

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

10810 Parkside Dr
Ste G-9
Knoxville, TN 37934
Phone (865) 218-6085

6408 Papermill Dr
Ste 220
Knoxville, TN 37919
Phone (865) 306-5675

Dept 888067
Knoxville, TN 37995

988 Oak Ridge Tpke
Ste 245
Oak Ridge, TN 37830
Phone (423) 482-9500

7714 Conner Rd
Ste 103
Powell, TN 37849
Phone (865) 938-6725

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 86

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 86

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752451200000",
    "number": "1750449443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52948",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379502948",
            "telephone_number": "865-306-5675",
            "fax_number": "865-584-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6408 PAPERMILL DR",
            "address_2": "SUITE 220",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194858",
            "telephone_number": "865-306-5675",
            "fax_number": "865-584-7712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SURGICAL ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A",
        "authorized_official_last_name": "ROM",
        "authorized_official_first_name": "JEROME",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "865-306-5675"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3707870",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.