Statesboro Ambulatory Surgery Center, Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

STATESBORO AMBULATORY SURGERY CENTER, INC

Practice address

95 Bel Air Drive
Statesboro, GA 30461

Phone

(912) 489-6519

Fax

(912) 764-7882

NPI assigned

Dec 1, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Robert W Cushner, D.P.M.

Title

Ceo/Owner

Phone

(912) 489-8727

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322697600000",
    "number": "1356619613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 BEL AIR DR",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304616879",
            "telephone_number": "912-489-6519",
            "fax_number": "912-764-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 BEL AIR DRIVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30461",
            "telephone_number": "912-489-6519",
            "fax_number": "912-764-7882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATESBORO AMBULATORY SURGERY CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-01",
        "last_updated": "2011-12-01",
        "status": "A",
        "authorized_official_last_name": "CUSHNER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "912-489-8727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER TRANSACTION ACCESS NUMBER",
            "identifier": "GRP4317",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000624896A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leon Edward Spencer, EDD
• Stephanie Lupita Spencer, LCSW
• Deborah Kay Stalcup, LMT
• Statesboro Ambul Surg Ctr Inc
• Statesboro Ambulatory Surgery Center Inc
• Statesboro Cardiology, PC
• Statesboro Children's Dental Center, PC
• Statesboro ENT & FPS Clinic, P.C. (Statesboro ENT & H Clinic)
• Statesboro ENT & Sinus Center
• Statesboro ENT Surgical Center

• Ambulatory Surgical Clinic/Center in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; 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.