Surgery Center of Cleveland

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0000000002 Issued in TN

Legal business name

SURGERY CENTER OF CLEVELAND

Practice address

137 25TH St NE
Cleveland, TN 37311-3944

Phone

(423) 472-7874

Fax

(423) 472-2881

NPI assigned

Oct 27, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Connie Delaine Jones, RN

Title

Administrator

Phone

(423) 472-7874

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306836606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 25TH ST NE",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113944",
            "telephone_number": "423-472-7874",
            "fax_number": "423-472-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 25TH ST NE",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113944",
            "telephone_number": "423-472-7874",
            "fax_number": "423-472-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER OF CLEVELAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "DELAINE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "423-472-7874",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "0000000002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "7806130",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "100920",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diedre Fay Suits, FNP-C
• Brooke Lynne Sukhanov, CLD
• Gulshan A Sultan, MD
• Summit Medical Group PLLC (Family Medicine Center)
• Super Discount Pharmacy
• Surgical Specialists PLLC
• Brittany Lynn Suttles
• Geneva Nicole Suttles
• Levi Sutton
• Jason B Swallows, PHARMD

• Ambulatory Surgical Clinic/Center in Cleveland, TN
• Providers in Cleveland, TN by specialty
• Ambulatory Surgical Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.