Jefferson ASC, LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Talbott, TN
NPI 1174128359 · NPPES record last updated Aug 21, 2024
Key facts
- NPI
- 1174128359
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- Legal business name
- JEFFERSON ASC, LLC
- Practice address
- 6242 W Andrew Johnson Hwy
Talbott, TN 37877-8604 - Phone
- (702) 271-8476
- NPI assigned
- Dec 3, 2020
- Organization subpart
- No
Authorized official
- Name
- Kristina Music
- Title
- Director of Provider Enrollment
- Phone
- (615) 465-7377
Member of 1
Medicare Care Compare: Ambulatory surgical center
- Listed as
- Jefferson ASC LLC Dba Volunteer Surgery Center
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D2221417 | Jefferson ASC, LLC | Certificate of waiver | Apr 20, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210318001413 | TN | Part B Supplier - Ambulatory Surgical Center | 2062829096 | Practice locations: Talbott, TN |
National Provider Directory
Locations
6242 W Andrew Johnson Hwy
Talbott, TN 37877
Phone (423) 690-3250
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Yes |
Addresses
Primary practice location
6242 W Andrew Johnson Hwy
Talbott, TN 37877-8604
Mailing address
6242 W Andrew Johnson Hwy
Talbott, TN 37877-8604
Phone (423) 690-3250
Other names
- Volunteer Surgery Center
Other providers in Talbott, TN
- Brittany Lashae Hunter
- Nathaly Marie Irizarry
- Melody Gilliam James
- Gail Jarnigan
- Kathryn Elizabeth Jaspers
- Chasity Jett
- Chelsea Nicole Johnson
- Kristin Lea Johnson
- Rosanne Kathleen Jones
- Alan Savage Jordan
All providers in Talbott, 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 Aug 21, 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.