Sedalia Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

261QA1903X Issued in MO

Legal business name

SEDALIA SURGERY CENTER, LLC

Practice address

3310 W 10TH St
Sedalia, MO 65301-2111

Phone

(660) 829-4024

Fax

(660) 829-2971

NPI assigned

Nov 11, 2005

Last updated

Jul 7, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Phyllis Fischer

Title

Business Office Manager

Phone

(660) 829-4024

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Listed as

Sedalia Surgery CenterCCN 26C0001065

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

• Stuart J Braverman, MD

  • Surgery Physician
  • Sedalia, MO
  • NPI 1740272376
  NPD (past)

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215388800000",
    "number": "1063493443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 W 10TH ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012111",
            "telephone_number": "660-829-4024",
            "fax_number": "660-829-2971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 W 10TH ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012111",
            "telephone_number": "660-829-4024",
            "fax_number": "660-829-2971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEDALIA SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-11",
        "last_updated": "2008-07-07",
        "status": "A",
        "authorized_official_last_name": "FISCHER",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "660-829-4024"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MO",
            "license": "261QA1903X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "506013507",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "91125019",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "43194001265301",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "91125019",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "491944012",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sedalia Health Group, LLC
• Sedalia Internal Medicine Specialists
• Sedalia Internal Medicine Specialists PC
• Sedalia Nursing Home Co (Fair View Nursing Home)
• Sedalia Optometric Clinic, Inc
• Sedalia Urgent Care LLC (AFC Urgent Care)
• Sedalia Urgent Care LLC (American Family Care)
• Sedalia Wellness Center, LLC
• Amie Michelle Seitz, DNP, APRN, FNP-BC
• Select Physical Therapy Holdings Inc (Select Physical Therapy)

• Ambulatory Surgical Clinic/Center in Sedalia, MO
• Providers in Sedalia, MO by specialty
• Ambulatory Surgical Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.