NPIMap

Organization Active NPI

Deerpath Ambulatory Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Morris, IL
National Provider Identifier
1215040464
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
DEERPATH AMBULATORY SURGICAL CENTER, LLC
Practice address
1051 W US Route 6
Morris, IL 60450
Phone
(815) 318-5666
Fax
(815) 318-5676
NPI assigned
Aug 15, 2006
Last updated
Sep 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Authorized official

Name
Ashley Hilliard
Title
Administrator
Phone
(815) 318-5626

Specialties & licenses 1

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

Addresses

Primary practice location

1051 W US Route 6
Morris, IL 60450

Mailing address

1051 W US Route 6
Morris, IL 60450-3349
Phone (815) 318-5666

Other names 1

  • Deerpath Orthopedic Surgical Center Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040902001234 IL Part B Supplier - Ambulatory Surgical Center 1254307069 Practice locations: Morris, IL

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Deerpath Ambulatory Surgical Center LLCCCN 14C0001106
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 1

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

  • Morris Hospital

    dba Morris Hospital & Healthcare Centers

    • General Practice Physician
    • Channahon, IL
    • NPI 1275648511

    Member Of

    NPD member

Practitioners & affiliated clinicians

Practitioners 44

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 44

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662076800000",
    "number": "1215040464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 W US ROUTE 6",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604503349",
            "telephone_number": "815-318-5666",
            "fax_number": "815-318-5676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 W US ROUTE 6",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "60450",
            "telephone_number": "815-318-5666",
            "fax_number": "815-318-5676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEERPATH AMBULATORY SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A",
        "authorized_official_last_name": "HILLIARD",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "815-318-5626"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deerpath Orthopedic Surgical Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Morris, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; 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.