Plastic Surgery Operative Suite, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PLASTIC SURGERY OPERATIVE SUITE, LLC

Practice address

230 Northside Dr
Valdosta, GA 31602-1858

Phone

(229) 242-3002

NPI assigned

Dec 26, 2007

Organization subpart

No

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

Authorized official

Name

Mandy Parks

Title

Practice Administrator

Phone

(229) 242-3002

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 11C0001229

Legal name

PLASTIC SURGERY OPERATIVE SUITE, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Aug 28, 2003

Last certification

Mar 20, 2018

Ownership / control type

Proprietary

Facility address

230 Northside Drive
Valdosta, GA 31602

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

CLIA laboratory certificates

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1316121429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 NORTHSIDE DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 NORTHSIDE DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021858",
            "telephone_number": "229-242-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY OPERATIVE SUITE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "MANDY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "229-242-3002"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandy Morris Pitts, N.P.
• Tabitha Pitts
• Timothy E Pitts, DPM
• James Leland Plair, FNP-C
• Plastic Surgery Associates of Valdosta
• Leslie Autumn Platt, M. ED. CCC-SLP
• Mark Arthur Pleasants, CRNA
• Katherine Ann Plyler, M. ED., CCC-SLP
• Chris Ann Plymale
• Reagan Plymale, M.ED., CF-SLP

• Ambulatory Surgical Clinic/Center in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.