Urologic Ambulatory Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

UROLOGIC AMBULATORY SURGERY CENTER, LLC

Practice address

499 Gloster Creek VLG Ste B8
Tupelo, MS 38801-4633

Phone

(662) 432-0700

Fax

(662) 846-0566

NPI assigned

Jan 9, 2017

Last updated

Oct 24, 2023By 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

Mrs. Deonne Henry

Title

Director of Operations

Phone

(662) 432-0700

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Listed as

Urologic Ambulatory Surgery CenterCCN 25C0001091

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 organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Urologic Reference Lab LLC

  • Urology Physician
  • Tupelo, MS
  • NPI 1689455305

  Member Of

  NPD member

Locations

Practitioners 7

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.

• Jeremy Scott Archer, MD

  • Urology Physician
  • Tupelo, MS
  • NPI 1386179232
  Medicare reassignment NPD
• Paul Farabaugh, MD

  • Urology Physician
  • Tupelo, MS
  • NPI 1881694347
  Medicare reassignment NPD
• Clarance Stephen Farmer II, MD

  • Urology Physician
  • Tupelo, MS
  • NPI 1407856958
  Medicare reassignment NPD
• Jonathan Kalish, MD

  • Urology Physician
  • Tupelo, MS
  • NPI 1205836764
  Medicare reassignment NPD
• William Hughes Milam, MD

  • Urology Physician
  • Tupelo, MS
  • NPI 1992797161
  Medicare reassignment NPD
• Jon T Posey, MD

  • Urology Physician
  • Tupelo, MS
  • NPI 1013917103
  Medicare reassignment NPD
• Kristopher Wayne Whitehead, M.D.

  • Urology Physician
  • Tupelo, MS
  • NPI 1700057106
  Medicare reassignment NPD

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1154867562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 829",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388020829",
            "telephone_number": "662-377-7100",
            "fax_number": "662-377-5736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 GLOSTER CREEK VLG STE B8",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014633",
            "telephone_number": "662-432-0700",
            "fax_number": "662-846-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGIC AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-09",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "DEONNE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "662-432-0700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• United Methodist Senior Services Health Care, Inc (Cedars Health Center)
• Unity Hospice Care, LLC
• Universal Medical Supplies & Rentals Inc (Precision Repair Network)
• Urgent Specialty Associates of Mississippi PLLC
• Urgent Specialty Associates of Mississippi PLLC
• Urologic Reference Lab LLC
• Urology Professional Association (Urologic)
• Austin Urvina, MD
• US Land Cruiser Non Profit Public Trans., Inc.
• Rana Muhammad Usman, MD

• Ambulatory Surgical Clinic/Center in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Ambulatory Surgical Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.