NPIMap

Organization Active NPI

Physicians Day Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Pine Bluff, AR
National Provider Identifier
1023057916
Registry record updated Oct 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
739 Issued in AR
Legal business name
PHYSICIANS DAY SURGERY CENTER
Practice address
2705 S Orlando St
Pine Bluff, AR 71603-4718
Phone
(870) 536-4100
Fax
(870) 536-9020
NPI assigned
Jun 6, 2006
Last updated
Oct 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2008

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

Authorized official

Name
Carolyn J Bowman
Title
Insurance Supervisor
Phone
(870) 536-4100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 739 AR Primary

Addresses

Primary practice location

2705 S Orlando St
Pine Bluff, AR 71603-4718

Mailing address

2705 S Orlando St
Pine Bluff, AR 71603-4718
Phone (870) 536-4100

Other identifiers 2

IdentifierTypeStateIssuer
1588603351OtherARNPI
113093128MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080929000775 AR Part B Supplier - Ambulatory Surgical Center 0143129254 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
Practice locations: Pine Bluff, AR

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Physicians Day Surgery CenterCCN 04C0001010
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
PDSC Anesthesia3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224201600000",
    "number": "1023057916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 S ORLANDO ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034718",
            "telephone_number": "870-536-4100",
            "fax_number": "870-536-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 S ORLANDO ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034718",
            "telephone_number": "870-536-4100",
            "fax_number": "870-536-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS DAY SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2008-10-17",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "INSURANCE SUPERVISOR",
        "authorized_official_telephone_number": "870-536-4100"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AR",
            "license": "739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1588603351",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113093128",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2008; 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.