Champaign Surgicenter, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

007002959 Issued in IL

Legal business name

CHAMPAIGN SURGICENTER, LLC

Practice address

3103 Fields South Dr
Champaign, IL 61822-3743

Phone

(217) 902-2300

Fax

(217) 902-7735

NPI assigned

Dec 8, 2006

Organization subpart

No

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

Authorized official

Name

James Leonard

Title

Ceo

Phone

(217) 383-3220

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Listed as

Carle SurgicenterCCN 14C0001076

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Tax ID family

Champaign Endoscopy Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Champaign Surgicenter, LLC

  • Ambulatory Surgical Clinic/Center
  • Champaign, IL
  • NPI 1134086069
  NPD tax ID

Member of 2

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

• Carle Clinic Assocation, P.C.

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1255380846

  Member Of

  NPD member
• Carle Health Care Incorporated

  • Durable Medical Equipment & Medical Supplies
  • Urbana, IL
  • NPI 1356664767

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James S Gregory, MD

  • Trauma Surgery Physician
  • Bloomsburg, PA
  • NPI 1073561635
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549411200000",
    "number": "1356400782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-326-2955",
            "fax_number": "217-326-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3103 FIELDS SOUTH DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618223743",
            "telephone_number": "217-902-2300",
            "fax_number": "217-902-7735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPAIGN SURGICENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2019-02-06",
        "status": "A",
        "authorized_official_last_name": "LEONARD",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-383-3220"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "007002959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PROV ID",
            "identifier": "025710",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Champaign Cu School District
• Champaign Endodontics PLLC
• Champaign Integrative Clinic, PLLC
• Champaign Rehabilitation Center LLC
• Champaign Surgicenter, LLC
• Champaign Treatment Center, LLC
• Champaign Urbana Public Health
• Champaign Urbana Public Health Department
• Champaign Urbana Public Health Department
• Champaign Urbana Public Health Department

• Ambulatory Surgical Clinic/Center in Champaign, IL
• Providers in Champaign, IL by specialty
• Ambulatory Surgical Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.