NPIMap

Organization Active NPI

Ambulatory Surgi-Center at FMC LLC

  • Ambulatory Surgical Clinic/Center
  • Flagstaff, AZ
National Provider Identifier
1154378909
Registry record updated Jun 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
OSC 2303 Issued in AZ
Legal business name
AMBULATORY SURGI-CENTER AT FMC LLC
Practice address
1200 N Beaver St Ste B
Flagstaff, AZ 86001-3118
Phone
(928) 214-2700
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2010

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

Authorized official

Name
Susan Novak
Title
Director
Phone
(928) 214-2700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X OSC 2303 AZ Primary

Addresses

Primary practice location

1200 N Beaver St Ste B
Flagstaff, AZ 86001-3118

Mailing address

PO Box 2730
Flagstaff, AZ 86003-2730
Phone (928) 214-2700

Other identifiers 4

IdentifierTypeStateIssuer
157543OtherAZUHC
1Z7274OtherAZHEALTHNET
478364MedicaidAZ
AZ0205860OtherAZBCBS/AZ

National Provider Directory

National Provider Directory

Member of 1

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

Locations

1200 N Beaver St
Ste B
Flagstaff, AZ 86001
Phone (928) 214-2700

Practitioners & affiliated clinicians

Practitioners 5

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": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276214400000",
    "number": "1154378909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2730",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860032730",
            "telephone_number": "928-214-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST STE B",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-214-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBULATORY SURGI-CENTER AT FMC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2010-06-11",
        "status": "A",
        "authorized_official_last_name": "NOVAK",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "928-214-2700"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "OSC 2303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "157543",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "1Z7274",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "478364",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/AZ",
            "identifier": "AZ0205860",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2010; 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.