The Outpatient Surgery Center of Cedar Rapids, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS, LLC

Doing business as

Surgery Center Cedar Rapids

Practice address

1075 1St Avenue SE
Cedar Rapids, IA 52402

Phone

(319) 558-4800

Fax

(319) 558-4806

NPI assigned

Jun 13, 2005

Last updated

Jan 2, 2019By 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

Kallemeyn Scott

Title

Executive Director

Phone

(319) 558-4801

Specialties & licenses 1

Addresses

Other names 1

• Surgery Center Cedar Rapids Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Listed as

Surgery Center Cedar RapidsCCN 16C0001016

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

Member of 3

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

• Physicians' Clinic of Iowa, PC

  • Radiology Clinic/Center
  • Cedar Rapids, IA
  • NPI 1861737710

  Member Of

  NPD member
• St. Luke's Jones Regional Medical Center

  dba Jones Regional Medical Center Physician Services

  • Emergency Medicine Physician
  • Anamosa, IA
  • NPI 1942397328

  Member Of

  NPD member
• St. Luke's Methodist Hospital

  dba St. Luke's Family Health Center

  • Family Medicine Physician
  • Cedar Rapids, IA
  • NPI 1578658738

  Member Of

  NPD member

Locations

Practitioners 2

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.

• Thomas Allen Simpson, M.D.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Iowa City, IA
  • NPI 1285672428
  NPD
• Gregory Rex Hill, MD

  • Orthopaedic Surgery Physician
  • Fort Dodge, IA
  • NPI 1457322745
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546387200000",
    "number": "1124022595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 1ST AVENUE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52402",
            "telephone_number": "319-558-4802",
            "fax_number": "319-558-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 1ST AVENUE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52402",
            "telephone_number": "319-558-4800",
            "fax_number": "319-558-4806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2019-01-02",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "KALLEMEYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "319-558-4801"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgery Center Cedar Rapids",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Surgery Center Cedar Rapids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Ambulatory Surgical Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; 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.