State Line Surgical Services, LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

STATE LINE SURGICAL SERVICES, LLC

Practice address

1310 Eastside Centre CT # 6-142
Mountain Home, AR 72653-2705

Phone

(520) 323-8732

Fax

(520) 547-1865

NPI assigned

Apr 29, 2009

Organization subpart

No

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

Authorized official

Name

Lacey Dinh

Title

Revenue Cycle Manager of Abs

Phone

(520) 258-0326

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450224000000",
    "number": "1003050444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6339 E SPEEDWAY BLVD STE 201",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857101147",
            "telephone_number": "520-323-8732",
            "fax_number": "520-547-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 EASTSIDE CENTRE CT # 6-142",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532705",
            "telephone_number": "520-323-8732",
            "fax_number": "520-547-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE LINE SURGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-29",
        "last_updated": "2015-12-16",
        "status": "A",
        "authorized_official_last_name": "DINH",
        "authorized_official_first_name": "LACEY",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER OF ABS",
        "authorized_official_telephone_number": "520-258-0326"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Springfield Neurological and Spine Institute
• Stacey M Johnson MD PA (Physicians Medical Center of the Ozarks)
• Ray Emerson Stahl Jr., MD
• Paula A Stapleton, LCSW
• Starcare of Arkansas
• State of Arkansas (Baxter County Health Unit)
• Kristi Varnado Steelman, P.T.
• Kevin Dean Steffen Jr., DPM
• Jennifer Steinmann
• Stephen D Vester DDS PA

• Health Maintenance Organization in Mountain Home, AR
• Providers in Mountain Home, AR by specialty
• Health Maintenance Organization in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.