Organization Active NPI

Lebonheur East Surgery Center II LP

  • Ambulatory Surgical Clinic/Center
  • Memphis, TN
National Provider Identifier
1073763652
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
0000000042 Issued in TN
Legal business name
LEBONHEUR EAST SURGERY CENTER II LP
Practice address
786 Estate Place
Memphis, TN 38120
Phone
(901) 287-4100
Fax
(901) 516-1755
NPI assigned
Sep 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

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

Authorized official

Name
Mrs. Sherrye B Crone, RN
Title
Administrator
Phone
(901) 516-1716

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 0000000042 TN Primary

Addresses

Primary practice location

786 Estate Place
Memphis, TN 38120

Mailing address

786 Estate Place
Memphis, TN 38120
Phone (901) 287-4100

Other identifiers 1

IdentifierTypeStateIssuer
0117229OtherTNBLUE CROSS/BLUE SHIELD

Other names 1

  • LeBonheur East Surgery Center LP Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090720000420 TN Part B Supplier - Ambulatory Surgical Center 9234281452 Practice locations: Memphis, TN

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Lebonheur East Surgery Center II LPCCN 44C0001037
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2053108Lebonheur East Surgery Center II LP786 Estate Place, Memphis, TN 38120Certificate of waiverJan 24, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328054400000",
    "number": "1073763652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "786 ESTATE PLACE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38120",
            "telephone_number": "901-287-4100",
            "fax_number": "901-516-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "786 ESTATE PLACE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38120",
            "telephone_number": "901-287-4100",
            "fax_number": "901-516-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEBONHEUR EAST SURGERY CENTER II LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-19",
        "last_updated": "2012-02-01",
        "status": "A",
        "authorized_official_last_name": "CRONE",
        "authorized_official_first_name": "SHERRYE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "901-516-1716",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "0000000042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "0117229",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LeBonheur East Surgery Center LP",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; 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.