Sville ASC No. 1 LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SVILLE ASC NO. 1 LLC

Doing business as

Starkville Pain Solutions

Practice address

110 Walker Way
Starkville, MS 39759-6607

Phone

(662) 377-5199

NPI assigned

Jan 25, 2024

Organization subpart

No

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

Authorized official

Name

Bruce Toppin

Title

Corporate Secretary

Phone

(662) 377-4229

Specialties & licenses 1

Addresses

Other names 1

• Starkville Pain Solutions Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Ambulatory surgical center certification: CCN 25C0001105

Legal name

STARKVILLE PAIN SOLUTIONS

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Aug 21, 2024

Last certification

Aug 21, 2024

Ownership / control type

Proprietary

Facility address

110 Walker Way
Starkville, MS 39759

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1225890288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 VARSITY DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014613",
            "telephone_number": "662-377-2774",
            "fax_number": "662-377-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 WALKER WAY",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397596607",
            "telephone_number": "662-377-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SVILLE ASC NO. 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "TOPPIN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "CORPORATE SECRETARY",
        "authorized_official_telephone_number": "662-377-4229"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Starkville Pain Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shirlianne Stirewalt, RN,BSN
• Stockman'S Supply, LLC
• Kaye W Stowell, FNP
• Rashida Sturgis, OCCUPATIONAL THERAPY
• Jessica McHan Sugg, MOT, OTR/L
• Luellyn Switzer, M.S., LPC
• Synergy Pharmacy LLC
• Paige Tabor, MOTR/L
• Aeriell B. Tallie, MA
• Ravali Tarigopula, M.D.

• Ambulatory Surgical Clinic/Center in Starkville, MS
• Providers in Starkville, MS by specialty
• Ambulatory Surgical Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.