PREMIER SURGICAL CENTER, LLC
NPI 1417228370
Clinic/Center - Ambulatory Surgical in Evanston, WY
NPI Status: Active since January 24, 2012
Contact Information
195 OVERTHRUST ROAD
EVANSTON, WY
ZIP 82930
Phone: (307) 444-3600
Fax: (307) 444-3610
- Organization
- Clinic/Center
- Ambulatory Surgical
- Accepts Insurance
- CLIA Number: 53D2036482
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 02-07-2028
About PREMIER SURGICAL CENTER, LLC
This page provides the complete NPI Profile along with additional information for Premier Surgical Center, Llc, a provider established in Evanston, Wyoming operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1417228370 assigned on January 2012. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 14 years ago. The authorized official of this NPI record is Mr. Stephen C Sheppard (Administrator)
- NPI
- 1417228370
- Provider Name
- PREMIER SURGICAL CENTER, LLC
- Entity Type
- Organization
- Location Address
- 195 OVERTHRUST ROAD EVANSTON, WY 82930
- Location Phone
- (307) 444-3600
- Location Fax
- (307) 444-3610
- Mailing Address
- 195 OVERTHRUST ROAD EVANSTON, WY 82930
- Mailing Phone
- (307) 444-3600
- Mailing Fax
- (307) 444-3610
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-24-2012
- Last Update Date
- 03-26-2012
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Ambulatory Surgical
- Taxonomy Code
- 261QA1903X
- Type
- Ambulatory Health Care Facilities
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueSelect Bronze Basic - PPO
- BlueSelect Bronze Core - PPO
- BlueSelect Expanded Bronze Standard without Kid's Dental - PPO
- BlueSelect Gold Core - PPO
- BlueSelect Gold HealthPlus - PPO
- BlueSelect Gold Standard without Kid's Dental - PPO
- BlueSelect Silver Classic - PPO
- BlueSelect Silver Classic without Kid's Dental - PPO
- BlueSelect Silver HealthPlus - PPO
- BlueSelect Silver HealthPlus without Kid's Dental - PPO
- BlueSelect Silver Standard without Kid's Dental - PPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Value HSA (No Referrals) - EPO
- UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Gold Standard (No Referrals) - EPO
- UHC Gold Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
- UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Silver Standard (No Referrals) - EPO
- UHC Silver Value ($0 Virtual Urgent Care, No Referrals) - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope
Biopsy of large bowel using a flexible endoscope
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk
Dilation of stomach outlet using a flexible endoscope
Incision of eardrum with placement of eardrum tube under general anesthesia
Incision of nasal sinus using an endoscope
Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level
Injection of substance into middle or upper spine canal using imaging guidance
Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography
Reshaping of nasal cartilage
Therapeutic fracture of nasal passages
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
This service was performed 47 times for 46 patientsA biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
This service was performed 44 times for 43 patientsColorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.
This service was performed 27 times for 27 patientsThis procedure involves expanding the opening of the stomach using a flexible tube with a light, called an endoscope. It helps improve food passage from the stomach to the small intestine. It's performed under sedation for patient comfort.
This service was performed 33 times for 32 patientsThis procedure involves making a small cut in the eardrum to drain fluid and alleviate pressure. A tiny tube is then inserted to keep the hole open and prevent further fluid buildup. General anesthesia is used to ensure patient comfort.
This service was performed 12 times for 11 patientsThis procedure, called endoscopic sinus surgery, involves using a thin, flexible tube with a light and camera on the end, known as an endoscope. It's inserted into the nasal passages to view and remove obstructions in the sinuses, helping to alleviate symptoms.
This service was performed 22 times for 12 patientsThis procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.
This service was performed 67 times for 35 patientsThis procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.
This service was performed 20 times for 13 patientsThis procedure involves injecting medicine into the sacroiliac joint, located in the lower back. The aim is to reduce inflammation and pain. Anesthetic is used for immediate pain relief, while a steroid helps decrease inflammation over time. Arthrography, a type of imaging, may be used for precision.
This service was performed 31 times for 11 patientsReshaping of nasal cartilage, also known as rhinoplasty, is a surgical procedure to modify the structure of the nose for aesthetic or functional purposes. It involves adjusting the cartilage and bone in the nose to achieve the desired shape or to improve breathing.
This service was performed 11 times for 11 patientsA therapeutic fracture of nasal passages is a medical procedure to correct issues with the nose's structure. It involves intentionally breaking and reshaping the nasal bones to improve breathing, correct deformities, or enhance appearance. This is done under anesthesia.
This service was performed 26 times for 26 patientsCLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 53D2036482
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- February 08, 2026
- Certificate Expiration Date
- February 07, 2028
- Laboratory Director
- JASON HAACK
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Premier Surgical Center, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1417228370, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 60 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417228370, enumerated as an "organization" on January 24, 2012.
The provider is located at 195 OVERTHRUST ROAD EVANSTON, WY 82930 and the phone number is (307) 444-3600.
Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.
The provider might be accepting Accepts: Blue Cross Blue Shield of Wyoming and. Please consult your insurance carrier or call the provider to verify.