Professional Surgical Assistants, Inc.

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

Legal business name

PROFESSIONAL SURGICAL ASSISTANTS, INC.

Practice address

107 Tunnel Hill Rd
Georgetown, IN 47122-9131

Phone

(812) 923-2050

Fax

(812) 923-2883

NPI assigned

Mar 13, 2023

Organization subpart

No

Name

Derric Renton, CSA, KCSA.

Title

President

Phone

(812) 923-2050

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 13, 2023.

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1346941804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 TUNNEL HILL RD",
            "city": "GEORGETOWN",
            "state": "IN",
            "postal_code": "471229131",
            "telephone_number": "812-923-2050",
            "fax_number": "812-923-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 TUNNEL HILL RD",
            "city": "GEORGETOWN",
            "state": "IN",
            "postal_code": "471229131",
            "telephone_number": "812-923-2050",
            "fax_number": "812-923-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL SURGICAL ASSISTANTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "RENTON",
        "authorized_official_first_name": "DERRIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-923-2050",
        "authorized_official_credential": "CSA, KCSA."
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.