NPIMap

Organization Active NPI

Physicians' Surgery Center of Fayetteville, LLC

  • Ambulatory Surgical Clinic/Center
  • Fayetteville, AR
National Provider Identifier
1285622845
Registry record updated Apr 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
AR4272 Issued in AR
Legal business name
PHYSICIANS' SURGERY CENTER OF FAYETTEVILLE, LLC
Practice address
3733 N Business Dr
Suite #101
Fayetteville, AR 72703-5203
Phone
(479) 527-0050
Fax
(479) 527-0030
NPI assigned
Oct 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2009

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

Authorized official

Name
Russ Greene, R.N.
Title
Administrator
Phone
(479) 527-0050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X AR4272 AR Primary

Addresses

Primary practice location

3733 N Business Dr
Suite #101
Fayetteville, AR 72703-5203

Mailing address

3733 N Business Dr
Suite #101
Fayetteville, AR 72703-5203
Phone (479) 527-0050

National Provider Directory

National Provider Directory

Locations

3733 N Business Dr
Fayetteville, AR 72703
Phone (479) 251-1016

3873 N Parkview Dr
Ste 1
Fayetteville, AR 72703
Phone (479) 527-0050

Practitioners & affiliated clinicians

Practitioners 5

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": "1128643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239840000000",
    "number": "1285622845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3733 N BUSINESS DR",
            "address_2": "SUITE #101",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035203",
            "telephone_number": "479-527-0050",
            "fax_number": "479-527-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3733 N BUSINESS DR",
            "address_2": "SUITE #101",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035203",
            "telephone_number": "479-527-0050",
            "fax_number": "479-527-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS' SURGERY CENTER OF FAYETTEVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-07",
        "last_updated": "2009-04-16",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "RUSS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "479-527-0050",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AR",
            "license": "AR4272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.