Physicians Surgery Center of Chattanooga, LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Chattanooga, TN
NPI 1164589032 · NPPES record last updated Jan 26, 2024
Key facts
- NPI
- 1164589032
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- Legal business name
- PHYSICIANS SURGERY CENTER OF CHATTANOOGA, LLC
- Practice address
- 924 Spring Creek Road
Chattanooga, TN 37412-3910 - Phone
- (423) 889-1600
- Fax
- (423) 889-2171
- NPI assigned
- Jan 2, 2007
- Organization subpart
- No
Authorized official
- Name
- Kristen Oconnor
- Title
- Officer / Authorized Official
- Phone
- (615) 376-7315
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Member of 2
Practitioners 24
-
Bryan T Affolter, CRNA
-
Barry E Inman, MDA
-
Elaidys E Alvarez, CRNA
-
Rebekah J Bennett, CRNA
-
Corey Micah Carpenter, M.D.
-
David Frost, CRNA
-
Ery Garcia, CRNA
-
Jonathan Hernandez, CRNA
-
Miranda K. Huskey, CRNA
-
Sharna Dawn Keehn, CRNA
-
Christi S. Kicklighter, CRNA
-
Monica M Lorren, CRNA
-
Clifford M. Myles, M.D.
-
Cristal Bell Page, CRNA
-
Richard L Rawson, CRNA
-
Melissa O Robertson, CRNA
-
Christina M Romero, CRNA
-
Holly Deanne Swinea, CRNA
-
Albert Romero, CRNA
-
Esme Herholdt Brown, M.D.
-
Elizabeth Jan Gillespie, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060202000955 | TN | Part B Supplier - Clinic/Group Practice | 8527072115 |
Receives reassigned benefits from 22 practitioners 1 other NPI on this enrollment Practice locations: Chattanooga, TN |
National Provider Directory
- Tax ID family
- Ability Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | |||
| Ambulatory Surgical Clinic/Center | 261QA1903X | Yes | ||
| Certified Registered Nurse Anesthetist |
367500000X |
Addresses
Primary practice location
924 Spring Creek Road
Chattanooga, TN 37412-3910
Mailing address
924 Spring Creek Road
Chattanooga, TN 37412-3910
Phone (423) 889-1600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DE2541 | Other | TN | RAILROAD MEDICARE |
Other names
- Anesthesia Services of PSCC
Other providers in Chattanooga, TN
- Marlenny Phoenix
- Physical Therapy Associates of Chattanooga, Inc
- Physicians Care PT
- Physicians Reference Laboratory, Inc.
- Physicians Surgery Center of Chattanooga, LLC
- Physicians Surgery Center of Chattanooga, LLC
- Tara Marie Pianko
- Jimmy Piayas
- Julius A. Piazza III
- Gloria Pickens
All providers in Chattanooga, TN · Ambulatory Surgical Clinic/Center in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.