NPIMap

Organization Active NPI

Great Basin Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Elko, NV
National Provider Identifier
1114984549
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
2172ASC-8 Issued in NV
Legal business name
GREAT BASIN SURGICAL CENTER, LLC
Practice address
855 Golfcourse Rd
Elko, NV 89801-3451
Phone
(775) 753-4700
Fax
(775) 753-4703
NPI assigned
Apr 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Authorized official

Name
Ms. Susanne Cross
Title
Office Manager
Phone
(775) 753-5571

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 2172ASC-8 NV Primary

Addresses

Primary practice location

855 Golfcourse Rd
Elko, NV 89801-3451

Mailing address

855 Golfcourse Rd
Elko, NV 89801-3451
Phone (775) 753-4700

Other identifiers 1

IdentifierTypeStateIssuer
004604001MedicaidNV

National Provider Directory

National Provider Directory

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 8

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": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426118400000",
    "number": "1114984549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 GOLFCOURSE RD",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898013451",
            "telephone_number": "775-753-4700",
            "fax_number": "775-753-4703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 GOLFCOURSE RD",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898013451",
            "telephone_number": "775-753-4700",
            "fax_number": "775-753-4703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT BASIN SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2015-03-12",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "SUSANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "775-753-5571",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NV",
            "license": "2172ASC-8",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004604001",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elko, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; 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.