Physician Surgery Center

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

PHYSICIAN SURGERY CENTER

Practice address

1500 Hwy 72 East
Rolla, MO 65401-0000

Phone

(573) 426-6301

Fax

(573) 426-6304

NPI assigned

Aug 8, 2008

Organization subpart

No

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

Authorized official

Name

Ann Deters

Title

President

Phone

(217) 342-2255

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1003062100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 NETWORK CENTRE DR",
            "address_2": "P.O. BOX 1294",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624014632",
            "telephone_number": "217-342-2255",
            "fax_number": "217-342-2619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 HWY 72 EAST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654010000",
            "telephone_number": "573-426-6301",
            "fax_number": "573-426-6304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-08",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "DETERS",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-342-2255"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "511377",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "514184",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "168305",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00443325",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phelps County Regional Medical Center
• Tracy Phenix
• Mary Jane Phifer, CNM, MS
• Madeleine A Philpot, M.D.
• Andrea Rose Phinney, MD
• Physician Surgery Center
• Physician Surgery Center LLC
• Kevin G Pickens, CRNA
• Arlis Klug Pilch
• Planned Parenthood Great Rivers-Missouri

• Certified Registered Nurse Anesthetist in Rolla, MO
• Providers in Rolla, MO by specialty
• Certified Registered Nurse Anesthetist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.