Organization Active NPI

Surgical Specialties, PSC.

  • Surgery Physician
  • Albany, KY
National Provider Identifier
1043361645
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
33185 Issued in KY
Legal business name
SURGICAL SPECIALTIES, PSC.
Practice address
250 Burkesville Rd
Albany, KY 42602-1604
Phone
(606) 387-3000
Fax
(606) 387-3307
NPI assigned
Jan 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Tracy Glenn Cross, M.D.
Title
Owner
Phone
(606) 387-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 33185 KY Primary

Addresses

Primary practice location

250 Burkesville Rd
Albany, KY 42602-1604

Mailing address

250 Burkesville Rd
Albany, KY 42602-1604
Phone (606) 387-3000

Other identifiers 1

IdentifierTypeStateIssuer
64033525MedicaidKY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043361645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 BURKESVILLE RD",
            "city": "ALBANY",
            "state": "KY",
            "postal_code": "426021604",
            "telephone_number": "606-387-3000",
            "fax_number": "606-387-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BURKESVILLE RD",
            "city": "ALBANY",
            "state": "KY",
            "postal_code": "426021604",
            "telephone_number": "606-387-3000",
            "fax_number": "606-387-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL SPECIALTIES, PSC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-387-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "KY",
            "license": "33185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64033525",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.