Bradenton Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BRADENTON SURGERY CENTER LLC

Practice address

4930 Bradenton Ave
Dublin, OH 43017

Phone

(614) 336-9000

Fax

(614) 336-9001

NPI assigned

Jan 4, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Brian K Dorner, MDNPI 1255392247

Title

Owner

Phone

(614) 336-9000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Listed as

Bradenton Surgery Center LLCCCN 36C0001325

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 2

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

• Brian K Dorner, MD

  • Plastic Surgery Physician
  • Dublin, OH
  • NPI 1255392247
  NPD Authorized official
• Dustin Reynolds, M.D.

  • Interventional Pain Medicine Physician
  • Westerville, OH
  • NPI 1801241757
  NPD (past)

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576540800000",
    "number": "1275040800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 BRADENTON AVE",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "43017",
            "telephone_number": "614-336-9000",
            "fax_number": "614-336-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 BRADENTON AVE",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "43017",
            "telephone_number": "614-336-9000",
            "fax_number": "614-336-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADENTON SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-04",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A",
        "authorized_official_last_name": "DORNER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-336-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Joseph Boyle, M.D.
• Karri Boyle
• Amanda Boyles, RN
• Christopher Bozeman
• Lisa Rae Bracale
• Gregory Bradley
• Kelsey Bradley, RBT, BS
• Monroe Andrew Bradley
• Ronald Keith Bradley
• Abigale Bradshaw

• Ambulatory Surgical Clinic/Center in Dublin, OH
• Providers in Dublin, OH by specialty
• Ambulatory Surgical Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.