NPIMap

Organization Active NPI

Physicians Surgery Center of Chattanooga, LLC

Doing business as Anesthesia Services of PSCC

  • Ambulatory Surgical Clinic/Center
  • Chattanooga, TN
National Provider Identifier
1164589032
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PHYSICIANS SURGERY CENTER OF CHATTANOOGA, LLC
Doing business as
Anesthesia Services of PSCC
Practice address
924 Spring Creek Road
Chattanooga, TN 37412-3910
Phone
(423) 889-1600
Fax
(423) 889-2171
NPI assigned
Jan 2, 2007
Last updated
Jan 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Authorized official

Name
Kristen Oconnor
Title
Officer / Authorized Official
Phone
(615) 376-7315

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary
Certified Registered Nurse Anesthetist 367500000X
Anesthesiology Physician 207L00000X

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 1

IdentifierTypeStateIssuer
DE2541OtherTNRAILROAD MEDICARE

Other names 1

  • Anesthesia Services of PSCC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Ability Network2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

924 Spring Creek Rd
East Ridge, TN 37412
Phone (423) 629-7688

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706227200000",
    "number": "1164589032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 SPRING CREEK ROAD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374123910",
            "telephone_number": "423-889-1600",
            "fax_number": "423-889-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 SPRING CREEK ROAD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374123910",
            "telephone_number": "423-889-1600",
            "fax_number": "423-889-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS SURGERY CENTER OF CHATTANOOGA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A",
        "authorized_official_last_name": "OCONNOR",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "OFFICER / AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-376-7315"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE2541",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anesthesia Services of PSCC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Anesthesia Services of PSCC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.