Organization Active NPI

CPS-Evansville ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Evansville, IN
National Provider Identifier
1255199865
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
CPS-EVANSVILLE ASC LLC
Practice address
6016 E Columbia St
Evansville, IN 47715
Phone
(812) 476-7111
Fax
(812) 476-7117
NPI assigned
Mar 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Authorized official

Name
Jason Lewis, MDNPI 1720127913
Title
Owner
Phone
(502) 314-5549

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

6016 E Columbia St
Evansville, IN 47715

Mailing address

223 Executive Park
Louisville, KY 40207-4202
Phone (502) 907-0356

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250129001614 IN Part B Supplier - Ambulatory Surgical Center 0547799058 Practice locations: Evansville, IN

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2315188CPS-Evansville ASC LLC6016 E Columbia St, Evansville, IN 47715Certificate of waiverDec 8, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1709856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750809600000",
    "number": "1255199865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 EXECUTIVE PARK",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074202",
            "telephone_number": "502-907-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6016 E COLUMBIA ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47715",
            "telephone_number": "812-476-7111",
            "fax_number": "812-476-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CPS-EVANSVILLE ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-08",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-314-5549",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; 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.