NPIMap

Organization Active NPI

North River Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Tuscaloosa, AL
National Provider Identifier
1215926993
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
U6303 Issued in AL
Legal business name
NORTH RIVER SURGICAL CENTER, LLC
Practice address
301 Rice Mine Rd NE
Tuscaloosa, AL 35406-2403
Phone
(205) 750-0022
Fax
(205) 750-2373
NPI assigned
Oct 17, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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

Authorized official

Name
Clarence D Howe, M.D.
Title
Medical Director
Phone
(205) 750-0022

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 10452 AL
Ambulatory Surgical Clinic/Center 261QA1903X U6303 AL Primary

Addresses

Primary practice location

301 Rice Mine Rd NE
Tuscaloosa, AL 35406-2403

Mailing address

301 Rice Mine Rd NE
Tuscaloosa, AL 35406-2403
Phone (205) 750-0022

Other identifiers 1

IdentifierTypeStateIssuer
ASC0052CMedicaidAL

Other names 1

  • North River Surgical Center, Inc. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050103000231 AL Part B Supplier - Ambulatory Surgical Center 9638137029 Receives reassigned benefits from 2 practitioners
Practice locations: Tuscaloosa, AL

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
North River Surgical Center LLCCCN 01C0001029
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.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366243200000",
    "number": "1215926993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 RICE MINE RD NE",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062403",
            "telephone_number": "205-750-0022",
            "fax_number": "205-750-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 RICE MINE RD NE",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062403",
            "telephone_number": "205-750-0022",
            "fax_number": "205-750-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH RIVER SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-17",
        "last_updated": "2013-04-18",
        "status": "A",
        "authorized_official_last_name": "HOWE",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "205-750-0022",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AL",
            "license": "10452",
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AL",
            "license": "U6303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ASC0052C",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North River Surgical Center, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; 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.