Bristol Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0000000052 Issued in TN

Legal business name

BRISTOL SURGERY CENTER, LLC

Practice address

350 Blountville Hwy
Suite 108
Bristol, TN 37620-0213

Phone

(423) 844-6120

Fax

(423) 844-6119

NPI assigned

May 27, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Karen J Williams

Title

Administrator

Phone

(423) 844-6120

Specialties & licenses 1

Addresses

Other identifiers 6

Member of 1

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

• Wellmont Health System

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1487690400

  Member Of

  NPD member

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232064000000",
    "number": "1013964063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 BLOUNTVILLE HWY",
            "address_2": "SUITE 108",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376200213",
            "telephone_number": "423-844-6120",
            "fax_number": "423-844-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 BLOUNTVILLE HWY",
            "address_2": "SUITE 108",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376200213",
            "telephone_number": "423-844-6120",
            "fax_number": "423-844-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2009-01-16",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "423-844-6120",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "0000000052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIGON BCBS",
            "identifier": "007192",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "TN0103",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "0004618082",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007679301",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3287075",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSBSTN",
            "identifier": "1000984",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bristol Orthotics & Prosthetics Inc.
• Bristol Pediatric Associates, P.C.
• Bristol Pediatric Dentistry PLLC
• Bristol Regional Women'S Center
• Bristol Surgery Center
• Bristol Surgical Associates PC
• Bristol Urological Associates, P.C.
• Ronald Mitchell Brizendine, LCSW
• Broadmore Senior Living
• Andrew Brockmyre, MD

• Ambulatory Surgical Clinic/Center in Bristol, TN
• Providers in Bristol, TN by specialty
• Ambulatory Surgical Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; 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.