Physicians Surgery Center of Chattanooga, LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Chattanooga, TN
NPI 1003861998 · NPPES record last updated Oct 15, 2024
Key facts
- NPI
- 1003861998
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- License
- 00071 (TN)
- Legal business name
- PHYSICIANS SURGERY CENTER OF CHATTANOOGA, LLC
- Practice address
- 924 Spring Creek Road
Chattanooga, TN 37412-3910 - Phone
- (423) 899-1600
- Fax
- (423) 889-2171
- NPI assigned
- May 23, 2006
- Organization subpart
- No
Authorized official
- Name
- Kristen Occonor
- Title
- Medicare Authorized Official
- Phone
- (615) 376-7315
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Member of 2
Practitioners 27
-
Monica M Lorren, CRNA
-
Bryan T Affolter, CRNA
-
Barry E Inman, MDA
-
Elaidys E Alvarez, CRNA
-
Rebekah J Bennett, CRNA
-
Esme Herholdt Brown, M.D.
-
Corey Micah Carpenter, M.D.
-
David Frost, CRNA
-
Ery Garcia, CRNA
-
James Walton George, M.D.
-
Jonathan Hernandez, CRNA
-
Miranda K. Huskey, CRNA
-
Sharna Dawn Keehn, CRNA
-
Christi S. Kicklighter, CRNA
-
Judith S Morton, CRNA
-
Clifford M. Myles, M.D.
-
Cristal Bell Page, CRNA
-
Richard L Rawson, CRNA
-
Melissa O Robertson, CRNA
-
Christina M Romero, CRNA
-
Holly Deanne Swinea, CRNA
-
Jaime Tessier, CRNA
Medicare Care Compare: Ambulatory surgical center
- Listed as
- Physicians Surgery Center of Chattanooga LLC Dba Physicians Surgery Center of Chattanooga
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100211000124 | TN | Part B Supplier - Ambulatory Surgical Center | 8527072115 |
Receives reassigned benefits from 1 practitioner Practice locations: Chattanooga, TN |
National Provider Directory
- Tax ID family
- Ability Network
Networks
- devoted network organization-8e25d2a3-4243-4ca7-9a42-cceb4e4f5c4b
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | 00071 | TN | Yes |
Addresses
Primary practice location
924 Spring Creek Road
Chattanooga, TN 37412-3910
Mailing address
924 Spring Creek Road
Chattanooga, TN 37412-3910
Phone (423) 899-1600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0873969A | Medicaid | GA | |
| 3288496 | Medicaid | TN |
Other names
- Physicians Surgery Center of Chattanooga
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Other providers in Chattanooga, TN
- Phoenix Health PLLC
- Marlenny Phoenix
- Physical Therapy Associates of Chattanooga, Inc
- Physicians Care PT
- Physicians Reference Laboratory, Inc.
- Physicians Surgery Center of Chattanooga, LLC
- Physicians Surgery Center of Chattanooga, LLC
- Tara Marie Pianko
- Jimmy Piayas
- Julius A. Piazza III
All providers in Chattanooga, TN · Ambulatory Surgical Clinic/Center in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.