Gazenko Surgical Services, PLLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

GAZENKO SURGICAL SERVICES, PLLC

Practice address

1010 W Main St
Clarksville, AR 72830-3417

Phone

(479) 705-2310

Fax

(479) 705-2300

NPI assigned

Jan 28, 2021

Organization subpart

No

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

Authorized official

Name

Kate Gazenko, MDNPI 1245435213

Title

Owner

Phone

(513) 806-6770

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gazenko Surgical & Cosmetics Center Doing business as

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22932/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Kate Roxalyn Gazenko, M.D.

  • Surgery Physician
  • Clarksville, AR
  • NPI 1245435213
  NPD Authorized official

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611792000000",
    "number": "1225629652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W MAIN ST",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728303417",
            "telephone_number": "479-705-2310",
            "fax_number": "479-705-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W MAIN ST",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728303417",
            "telephone_number": "479-705-2310",
            "fax_number": "479-705-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAZENKO SURGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A",
        "authorized_official_last_name": "GAZENKO",
        "authorized_official_first_name": "KATE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "513-806-6770",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210971001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gazenko Surgical & Cosmetics Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Abigail Garrett
• Amber Leigh Garrison, OT-A
• Susan Gateley, A.P.N.
• Ashley N Gattis, NP
• Gazenko Aesthetics LLC
• Kate Roxalyn Gazenko, M.D.
• Loretta J Gedosh, LPC
• Sydni Gibbs
• Alonzo Gilbert
• Gill-West Companies, Inc.

• Surgery Physician in Clarksville, AR
• Providers in Clarksville, AR by specialty
• Surgery Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.