Southwest Surgical Partners LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0558AS Issued in OH

Legal business name

SOUTHWEST SURGICAL PARTNERS LLC

Practice address

3559 Kemp Rd
Suite 120
Beavercreek, OH 45431-2533

Phone

(937) 458-4100

Fax

(937) 458-4119

NPI assigned

Jan 16, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Larry Gault

Title

Administrator

Phone

(937) 458-4201

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Beavercreek Surgery Center Doing business as

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336128479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3559 KEMP RD",
            "address_2": "SUITE 120",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312533",
            "telephone_number": "937-458-4100",
            "fax_number": "937-458-4119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3559 KEMP RD",
            "address_2": "SUITE 120",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312533",
            "telephone_number": "937-458-4100",
            "fax_number": "937-458-4119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST SURGICAL PARTNERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GAULT",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "937-458-4201",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OH",
            "license": "0558AS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2139948",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beavercreek Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yousif Sobhi
• Solace Holistic Care LLC
• Solutions Health & Wellness LLC
• Lisa Sonterre-Hausfeld
• Melissa M Southwell, CNM
• Rachael Nicole Spady, MD
• Specialty Medicine Care, LLC
• Carmen Marie Speller, LPC
• Paul A. Speros, O.D.
• Philip James Spicer, APRN

• Ambulatory Surgical Clinic/Center in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Ambulatory Surgical Clinic/Center in Ohio

• 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.