Urlogy Ambulatory Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0000000134 Issued in TN

Legal business name

URLOGY AMBULATORY SURGERY CENTER LLC

Practice address

1325 Wolf Park Drive
Suite 101
Germantown, TN 38138

Phone

(901) 252-3403

Fax

(901) 516-1755

NPI assigned

Jan 18, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Sherrye B Crone, RN

Title

Administrator

Phone

(901) 516-1716

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Wolf River Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Listed as

Urlogy Ambulatory Surgery Center LLCCCN 44C0001118

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

Locations

Practitioners 1

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

• Holt Benjamin Maddux Jr., M.D.

  • Urology Physician
  • Germantown, TN
  • NPI 1275590606
  NPD (past)

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328054400000",
    "number": "1366422370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 WOLF PARK DRIVE",
            "address_2": "SUITE 101",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "38138",
            "telephone_number": "901-252-3403",
            "fax_number": "901-516-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 WOLF PARK DRIVE",
            "address_2": "SUITE 101",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "38138",
            "telephone_number": "901-252-3403",
            "fax_number": "901-516-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URLOGY AMBULATORY SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-18",
        "last_updated": "2012-02-01",
        "status": "A",
        "authorized_official_last_name": "CRONE",
        "authorized_official_first_name": "SHERRYE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "901-516-1716",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "134",
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "0000000134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4046074",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3288661",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490005620",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wolf River Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alice Nicole Kircher Uhlhorn, NP
• Michael Ulm, M.D, M.S.
• Heidi R Umphrey, M.D.
• Emilie H Unglesby, LCSW
• Unity Healthcare Services, LLC
• Urology Group PC
• Daniel Alberto Vaena, MD
• Jennifer Lou Valli, PHD
• Ettienne R. Van Zyl, D.D.S.
• Virginia Ekaterina Vanausdall, OTR/L

• Ambulatory Surgical Clinic/Center in Germantown, TN
• Providers in Germantown, TN by specialty
• Ambulatory Surgical Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; 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.