NPIMap

Organization Active NPI

Sutter Amador Surgery Center LLC

Doing business as Sutter Amador Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Jackson, CA
National Provider Identifier
1033453311
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SUTTER AMADOR SURGERY CENTER LLC
Doing business as
Sutter Amador Surgery Center
Practice address
223 Clinton Rd
Ste 204
Jackson, CA 95642-2680
Phone
(209) 223-5938
Fax
(209) 257-1599
NPI assigned
Nov 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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

Authorized official

Name
Mr. William D. Davis
Title
Board Chairman
Phone
(916) 286-8202

Specialties & licenses 1

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

Addresses

Primary practice location

223 Clinton Rd
Ste 204
Jackson, CA 95642-2680

Mailing address

223 Clinton Rd
Ste 204
Jackson, CA 95642-2680
Phone (209) 223-5938

Other names 1

  • Sutter Amador Surgery Center Doing business as

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Sutter Amador Surgery Center LLCCCN 05C0001640
Medicare certification status
Terminated Voluntary: merger or closure, Oct 31, 2025From the Provider of Services file

National Provider Directory

National Provider Directory

Member of 2

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

NPI Registry JSON

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353888000000",
    "number": "1033453311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 CLINTON RD",
            "address_2": "STE 204",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422680",
            "telephone_number": "209-223-5938",
            "fax_number": "209-257-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 CLINTON RD",
            "address_2": "STE 204",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422680",
            "telephone_number": "209-223-5938",
            "fax_number": "209-257-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER AMADOR SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-26",
        "last_updated": "2012-11-26",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "BOARD CHAIRMAN",
        "authorized_official_telephone_number": "916-286-8202",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sutter Amador Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.