Surgery Center of Zachary, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SURGERY CENTER OF ZACHARY, LLC

Practice address

4845 Main St
Ste a
Zachary, LA 70791

Phone

(817) 556-8387

NPI assigned

Mar 14, 2011

Organization subpart

No

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

Authorized official

Name

Karen S Mouch, RN

Title

Administrator

Phone

(225) 306-0100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Listed as

Surgery Center of Zachary LLCCCN 19C0001127

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 1

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

• Hospital Service District 1 of East Baton Rouge Parish

  dba Lane Regional Medical Center

  • Rehabilitation Hospital
  • Zachary, LA
  • NPI 1467400036

  Member Of

  NPD member

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

{
    "created_epoch": "1300060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460332800000",
    "number": "1134427297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4845 MAIN ST",
            "address_2": "STE A",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "70791",
            "telephone_number": "817-556-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4845 MAIN ST",
            "address_2": "STE A",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "70791",
            "telephone_number": "817-556-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER OF ZACHARY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-14",
        "last_updated": "2016-04-11",
        "status": "A",
        "authorized_official_last_name": "MOUCH",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "225-306-0100",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dainelle Renee Gordon Story, MSN, APRN, FNP-C
• Amy Sullivan, M.S.-SLP
• Kara Neal Sullivan, NP
• Keauna Sullivan, RN, BSN
• Sullivan's Pharmacy, LTD.
• Samantha Lynn Sutton, PHARMD
• Carol S Swift, M.D.
• Lovie Tabron, A.T.C., LAT
• Amanda Lavigne Talbot, MD
• Catherine Grace Talbot

• Ambulatory Surgical Clinic/Center in Zachary, LA
• Providers in Zachary, LA by specialty
• Ambulatory Surgical Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.