NPIMap

Organization Active NPI

Southern Alabama Surgery Center LLC

Doing business as Surgery Center South

  • Ambulatory Surgical Clinic/Center
  • Dothan, AL
National Provider Identifier
1346349164
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SOUTHERN ALABAMA SURGERY CENTER LLC
Doing business as
Surgery Center South
Practice address
2800 Ross Clark Cir
Suite 3
Dothan, AL 36301-2040
Phone
(334) 793-3411
Fax
(334) 712-0227
NPI assigned
Sep 21, 2006
Last updated
Oct 23, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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

Authorized official

Name
Mrs. Sharron Alane Byrd
Title
Administer
Phone
(334) 793-3411

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 12124 AL
Clinic/Center 261Q00000X NU
Ambulatory Surgical Clinic/Center 261QA1903X NU Primary
Certified Registered Nurse Anesthetist 367500000X NU
Anesthesiology Physician 207L00000X NU

Addresses

Primary practice location

2800 Ross Clark Cir
Suite 3
Dothan, AL 36301-2040

Mailing address

2800 Ross Clark Circle
Suite 3
Dothan, AL 36301
Phone (334) 793-3411

Other identifiers 6

IdentifierTypeStateIssuer
000902316AMedicaidGA
010306OtherALBLUE CROSS BLUE SHIELD
128616MedicaidAL
03119876AMedicaidGA
062936700MedicaidFL
ASC0060CMedicaidAL

Other names 1

  • Surgery Center South Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050112000767 AL Part B Supplier - Ambulatory Surgical Center 2062461460 Receives reassigned benefits from 72 practitioners
Practice locations: Dothan, AL

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Southern Alabama Surgery Center LLCCCN 01C0001010
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0894124Surgery Center South2800 Ross Clark Circle Suite 3, Dothan, AL 36301Certificate of waiverDec 20, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 74

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 74

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414022400000",
    "number": "1346349164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 ROSS CLARK CIRCLE",
            "address_2": "SUITE 3",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36301",
            "telephone_number": "334-793-3411",
            "fax_number": "334-712-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 ROSS CLARK CIR",
            "address_2": "SUITE 3",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363012040",
            "telephone_number": "334-793-3411",
            "fax_number": "334-712-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ALABAMA SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2014-10-23",
        "status": "A",
        "authorized_official_last_name": "BYRD",
        "authorized_official_first_name": "SHARRON",
        "authorized_official_middle_name": "ALANE",
        "authorized_official_title_or_position": "ADMINISTER",
        "authorized_official_telephone_number": "334-793-3411",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AL",
            "license": "12124",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000902316A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "010306",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128616",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03119876A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062936700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ASC0060C",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgery Center South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; 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.