Saint Charles Surgical Pavilion Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

SAINT CHARLES SURGICAL PAVILION INC

Practice address

1900 Saint Charles St
Jasper, IN 47546-9145

Phone

(812) 634-1211

Fax

(812) 634-9762

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Randall G Norris, MD

Title

Owner/Ceo

Phone

(812) 634-1211

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Saint Charles Surgical Pavilion Inc

  • Certified Registered Nurse Anesthetist
  • Jasper, IN
  • NPI 1952486862

  O20040220000838

  Same enrollment

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326412800000",
    "number": "1295810109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SAINT CHARLES ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475469145",
            "telephone_number": "812-634-1211",
            "fax_number": "812-634-9762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SAINT CHARLES ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475469145",
            "telephone_number": "812-634-1211",
            "fax_number": "812-634-9762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT CHARLES SURGICAL PAVILION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2012-01-13",
        "status": "A",
        "authorized_official_last_name": "NORRIS",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "812-634-1211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi L Routson, LSW
• Chloe Roy, COTA
• Paul Andrew Ruell, MSW, 99043894A
• Michael E Ruff, MD
• Tatyana Evalin Ruiz
• Saint Charles Surgical Pavilion Inc
• Saint Charles Surgical Pavilion Inc
• Sarah Saladin
• Stephen Curry Sample, M.D.
• Melinda Sams, L.C.S.W.

• All providers in Jasper, IN
• Anesthesiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.

Verify at the official NPI Registry.