Grogan's Mill Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

GROGAN'S MILL SURGERY CENTER, LLC

Doing business as

Creekside Surgery Center

Practice address

10847 Kuykendahl Rd
Suite 150
The Woodlands, TX 77382-2777

Phone

(281) 292-5620

NPI assigned

Nov 11, 2011

Organization subpart

No

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

Authorized official

Name

Cindy L Broderick, RN

Title

Administrator

Phone

(281) 292-5620

Specialties & licenses 1

Addresses

Other names 1

• Creekside Surgery Center Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 45C0001641

Legal name

CREEKSIDE SURGERY CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Apr 17, 2018

Last certification

Apr 17, 2018

Ownership / control type

Proprietary

Facility address

10847 Kuykendahl Rd, Ste 150
The Woodlands, TX 77382

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

{
    "created_epoch": "1320969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339113600000",
    "number": "1083991582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10847 KUYKENDAHL RD",
            "address_2": "SUITE 150",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773822777",
            "telephone_number": "281-292-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10847 KUYKENDAHL RD",
            "address_2": "SUITE 150",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773822777",
            "telephone_number": "281-292-5620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROGAN'S MILL SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-11",
        "last_updated": "2012-06-08",
        "status": "A",
        "authorized_official_last_name": "BRODERICK",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "281-292-5620",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creekside Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joshua Scott Griffin, M.D.
• Laura Lynne Griswold, MPT
• Joey Kevin Grochmal, MD, PHD
• Allison R Grodzki, PSY.D.
• Alice Margaret Grogan, MD
• Grogans Mill Dental, PC
• Lauren Grona Wells, PT, DPT
• Michael Patrick Groves, MA, NCC, LPC
• Gtbe Endeavors, Inc.
• Jaime Guajardo Jr., LCSW

• Ambulatory Surgical Clinic/Center in The Woodlands, TX
• Providers in The Woodlands, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.