Grand Island Surgical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

ASC008 Issued in NE

Legal business name

GRAND ISLAND SURGICAL CENTER LLC

Practice address

3610 Richmond Cir
Grand Island, NE 68803-3927

Phone

(308) 384-6400

Fax

(308) 398-6420

NPI assigned

May 23, 2005

Organization subpart

No

Name

Mr. Ken Terry

Title

Administrator

Phone

(308) 384-6400

Organizations this organization is a member of, according to the National Provider Directory.

• Saint Francis Medical Center

  • Skilled Nursing Facility
  • Grand Island, NE
  • NPI 1629049614

  Member Of

  NPD member

Listed as

Grand Island Surgery CenterCCN 28C0001019

Medicare certification status

ActiveFrom the Provider of Services file

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 23, 2011.

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308787200000",
    "number": "1316940539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5434",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688025434",
            "telephone_number": "308-384-6400",
            "fax_number": "308-398-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 RICHMOND CIR",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688033927",
            "telephone_number": "308-384-6400",
            "fax_number": "308-398-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND ISLAND SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2011-06-23",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "308-384-6400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NE",
            "license": "ASC008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "01383",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR PROVIDER ID",
            "identifier": "490004345",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grand Island Public Schools
• Grand Island Radiology Associates PC
• Grand Island Regional Medical Center
• Grand Island Regional Medical Center
• Grand Island Regional Medical Center
• Yudisleidis Grangel
• Lori Ann Grant
• Frederic Masada Graves
• Heather Graves
• Jennifer Gray, PLMHP

• All providers in Grand Island, NE
• Ambulatory Surgical Clinic/Center in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; 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.