Mayfield Ambulatory Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MAYFIELD AMBULATORY SURGERY CENTER, LLC

Practice address

1710 Mayfield Dr
Jonesboro, AR 72401-4563

Phone

(844) 215-0731

Fax

(888) 630-8885

NPI assigned

Feb 16, 2022

Organization subpart

No

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

Authorized official

Name

Elizabeth Waddell, RN

Title

ASC Administrator

Phone

(501) 766-1065

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 04C0001115

Legal name

Mayfield Ambulatory Surgery Center

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Oct 5, 2023

Last certification

Sep 1, 2023

Ownership / control type

Proprietary

Facility address

1710 Mayfield Drive
Jonesboro, AR 72401

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644969600000",
    "number": "1245985407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N SHACKLEFORD RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722112840",
            "telephone_number": "844-215-0731",
            "fax_number": "888-630-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 MAYFIELD DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014563",
            "telephone_number": "844-215-0731",
            "fax_number": "888-630-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYFIELD AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-16",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A",
        "authorized_official_last_name": "WADDELL",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "ASC ADMINISTRATOR",
        "authorized_official_telephone_number": "501-766-1065",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maxus
• Maxus Inc.
• James Maxwell, MD
• Jackson Neal May, LPC
• Leslie Mayberry
• David C. Maynard, LAC
• Bethany Mayo
• James Mayo
• Carnecia Mays, QBHP
• Derika B Mays, DO

• Ambulatory Surgical Clinic/Center in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Ambulatory Surgical Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; 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.
• 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.