Organization Active NPI

Surgery Center of Farmington, LLC

  • Anesthesiology Physician
  • Farmington, MO
National Provider Identifier
1033180658
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
SURGERY CENTER OF FARMINGTON, LLC
Practice address
400 Parkland Dr
Farmington, MO 63640-2906
Phone
(573) 756-8000
Fax
(573) 756-8288
NPI assigned
Jan 31, 2006
Last updated
Jun 3, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
SURGERY CENTER OF FARMINGTON LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

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

Authorized official

Name
Lesley Ann Wigger
Title
Business Office Manager
Phone
(573) 756-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

400 Parkland Dr
Farmington, MO 63640-2906

Mailing address

400 Parkland Dr
Farmington, MO 63640-2906
Phone (573) 756-8000

Other identifiers 4

IdentifierTypeStateIssuer
1326103490OtherMONPI
1942312061OtherMONPI
1437104304OtherMONPI
504759218MedicaidMO

National Provider Directory

National Provider Directory
Part of
The Surgery Center of F

Locations

400 Parkland Dr
Farmington, MO 63640
Phone (303) 755-3201

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433289600000",
    "number": "1033180658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 PARKLAND DR",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636402906",
            "telephone_number": "573-756-8000",
            "fax_number": "573-756-8288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PARKLAND DR",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636402906",
            "telephone_number": "573-756-8000",
            "fax_number": "573-756-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER OF FARMINGTON, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SURGERY CENTER OF FARMINGTON LLC",
        "enumeration_date": "2006-01-31",
        "last_updated": "2015-06-03",
        "status": "A",
        "authorized_official_last_name": "WIGGER",
        "authorized_official_first_name": "LESLEY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "573-756-8000"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1326103490",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1942312061",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1437104304",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "504759218",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; 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.