Specialty ASC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

3406ASC-8 Issued in NV

Legal business name

SPECIALTY ASC LLC

Doing business as

Surgical Arts Center

Practice address

9499 W Charleston Blvd Ste 250
Las Vegas, NV 89117-7148

Phone

(702) 933-3600

Fax

(702) 933-3601

NPI assigned

Sep 4, 2008

Last updated

Oct 10, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Michelle Bennion

Title

Administrator

Phone

(702) 933-3600

Specialties & licenses 1

Addresses

Other names 1

• Surgical Arts Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Specialty ASC LLC

  dba Surgical Arts Center

  • Ambulatory Surgical Clinic/Center
  • Las Vegas, NV
  • NPI 1083669196

  9537372099

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Specialty ASC LLC

  dba Surgical Arts Center

  • Ambulatory Surgical Clinic/Center
  • Las Vegas, NV
  • NPI 1083669196

  O20100930083198

  Same enrollment

Practitioners 2

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.

• Michael John McKenna, M.D.

  • Interventional Pain Medicine Physician
  • Las Vegas, NV
  • NPI 1093736571
  NPD (past)
• Brian Juel Parker, MD

  • Plastic Surgery Physician
  • Las Vegas, NV
  • NPI 1952493223
  NPD (past)

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318204800000",
    "number": "1003064890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9499 W CHARLESTON BLVD STE 250",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891177148",
            "telephone_number": "702-933-3600",
            "fax_number": "702-933-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9499 W CHARLESTON BLVD STE 250",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891177148",
            "telephone_number": "702-933-3600",
            "fax_number": "702-933-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-04",
        "last_updated": "2011-10-10",
        "status": "A",
        "authorized_official_last_name": "BENNION",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "702-933-3600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NV",
            "license": "3406ASC-8",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgical Arts Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialized Alternatives for Families and Youth of Nevada, Inc. (SAFY of Nevada)
• Specialized Care Services LLC
• Specialty ASC LLC (Surgical Arts Center)
• Specialty Hospice Care LLC
• Specialty Surgery Center of Pecos, LLC (Outpatient Surgical Center of Flamingo)
• Specialty Surgicare of Las Vegas, LP (Specialty Surgery Center)
• Eugene Lewis Speck, M.D. PH. D.

• Ambulatory Surgical Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Ambulatory Surgical Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; 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.