NPIMap

Organization Active NPI

Physicians Surgery Center of Chattanooga, LLC

Doing business as Physicians Surgery Center of Chattanooga

  • Ambulatory Surgical Clinic/Center
  • Chattanooga, TN
National Provider Identifier
1003861998
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
00071 Issued in TN
Legal business name
PHYSICIANS SURGERY CENTER OF CHATTANOOGA, LLC
Doing business as
Physicians Surgery Center of Chattanooga
Practice address
924 Spring Creek Road
Chattanooga, TN 37412-3910
Phone
(423) 899-1600
Fax
(423) 889-2171
NPI assigned
May 23, 2006
Last updated
Oct 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Authorized official

Name
Kristen Occonor
Title
Medicare Authorized Official
Phone
(615) 376-7315

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 00071 TN Primary

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 names 1

  • Physicians Surgery Center of Chattanooga Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100211000124 TN Part B Supplier - Ambulatory Surgical Center 8527072115 Receives reassigned benefits from 1 practitioner
Practice locations: Chattanooga, TN

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Physicians Surgery Center of Chattanooga LLC Dba Physicians Surgery Center of ChattanoogaCCN 44C0001060
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Ability Network2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Networks

  • devoted network organization-8e25d2a3-4243-4ca7-9a42-cceb4e4f5c4b

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1003861998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 SPRING CREEK ROAD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374123910",
            "telephone_number": "423-899-1600",
            "fax_number": "423-889-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 SPRING CREEK ROAD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374123910",
            "telephone_number": "423-899-1600",
            "fax_number": "423-889-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS SURGERY CENTER OF CHATTANOOGA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "OCCONOR",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "MEDICARE AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-376-7315"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "00071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Physicians Surgery Center of Chattanooga",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Physicians Surgery Center of Chattanooga",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.