PREMIER SURGICAL SUITES LLC – NPI #1215892781
Clinic/Center

PREMIER SURGICAL SUITES LLC is an AHC clinic located in PHOENIX, AZ. NPPES has assigned the NPI number 1215892781 to PREMIER SURGICAL SUITES LLC on December 17, 2025. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was last updated on May 28, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PREMIER SURGICAL SUITES LLC below.

NPI Profile for
PREMIER SURGICAL SUITES LLC

NPI Number
1215892781
Enumeration Date

(about 6 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PREMIER SURGICAL SUITES LLC
Primary location
3840 N 16TH ST
PHOENIX, AZ 85016-5917
Phone: (602) 232-6066 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JACKIE WIEDEMANN
BILLING MANAGER
Phone: (816) 610-8511
Updated
Certification Date
May 28, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)
261QS0132X
- Clinic/Center / Ophthalmologic Surgery

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.