Active NPI
Fort Sutter Surgery Center
- Ambulatory Surgical Clinic/Center
- Sacramento, CA
National Provider Identifier
1235480476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- FORT SUTTER SURGERY CENTER
- Doing business as
- Sutter River City Surgery Center
- Practice address
- 75 Scripps Dr
Sacramento, CA 95825-6320 - Phone
- (916) 929-9431
- Fax
- (916) 929-0132
- NPI assigned
- Sep 27, 2012
- Organization subpart
- Yes
- Parent organization
- FORT SUTTER SURGERY CENTER
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- William D. Davis
- Title
- Chairman
- Phone
- (916) 286-8202
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
75 Scripps Dr
Sacramento, CA 95825-6320
Mailing address
2801 K St
Suite 525
Sacramento, CA 95816-5120
Phone (916) 733-5017
Other names 1
- Sutter River City Surgery Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050113000335 | CA | Part B Supplier - Ambulatory Surgical Center | 8628027919 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Sacramento, CA |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Ambulatory Surgical Clinic/Center
- Sacramento, CA
- NPI 1164484572
O20050113000335
National Provider Directory
National Provider Directory- Part of
- Alhambra Surgery Ctrdi
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348704000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1355011200000",
"number": "1235480476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 K ST",
"address_2": "SUITE 525",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958165120",
"telephone_number": "916-733-5017",
"fax_number": "916-733-8738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 SCRIPPS DR",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958256320",
"telephone_number": "916-929-9431",
"fax_number": "916-929-0132"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FORT SUTTER SURGERY CENTER",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "FORT SUTTER SURGERY CENTER",
"enumeration_date": "2012-09-27",
"last_updated": "2012-12-09",
"status": "A",
"authorized_official_last_name": "DAVIS",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "D.",
"authorized_official_title_or_position": "CHAIRMAN",
"authorized_official_telephone_number": "916-286-8202"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Sutter River City Surgery Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.