NPIMap

Organization Active NPI

Prime Healthcare Services - Leavenworth Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Leavenworth, KS
National Provider Identifier
1124489083
Registry record updated Mar 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PRIME HEALTHCARE SERVICES - LEAVENWORTH SURGERY CENTER, LLC
Practice address
3550 S 4TH St
Suite G1
Leavenworth, KS 66048-5071
Phone
(913) 680-6400
NPI assigned
Mar 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2016

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

Authorized official

Name
Randall G Nyp
Title
Chief Executive Officer
Phone
(913) 596-3930

Specialties & licenses 1

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

Addresses

Primary practice location

3550 S 4TH St
Suite G1
Leavenworth, KS 66048-5071

Mailing address

3500 S 4TH St
Leavenworth, KS 66048-5043
Phone (913) 680-6400

Other names 1

  • Saint John Surgery Center Doing business as

National Provider Directory

National Provider Directory

Member of 1

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

Locations

3550 S 4th St
Ste G1
Leavenworth, KS 66048
Phone (913) 680-6400

Practitioners & affiliated clinicians

Practitioners 1

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": "1458259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458259200000",
    "number": "1124489083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 S 4TH ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660485043",
            "telephone_number": "913-680-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 S 4TH ST",
            "address_2": "SUITE G1",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660485071",
            "telephone_number": "913-680-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES - LEAVENWORTH SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-18",
        "last_updated": "2016-03-18",
        "status": "A",
        "authorized_official_last_name": "NYP",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "913-596-3930"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saint John Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leavenworth, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; 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.