Parkway Surgery Center, LLC.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

2147ASC Issued in NV

Legal business name

PARKWAY SURGERY CENTER, LLC.

Practice address

100 N Green Valley Pkwy
Ste 125
Henderson, NV 89074-6392

Phone

(702) 616-4954

Fax

(702) 269-0436

NPI assigned

Jun 9, 2005

Organization subpart

No

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

Authorized official

Name

Eric Boon

Title

Officer / Authorized Official

Phone

(480) 567-0269

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Parkway Surgery Center Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Parkway Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Henderson, NV
  • NPI 1649655515

  O20120306000520

  Same enrollment

Listed as

Parkway Surgery CenterCCN 29C0001036

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

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1366446189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N GREEN VALLEY PKWY",
            "address_2": "STE 125",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890746392",
            "telephone_number": "702-616-4954",
            "fax_number": "702-269-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N GREEN VALLEY PKWY",
            "address_2": "STE 125",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890746392",
            "telephone_number": "702-616-4954",
            "fax_number": "702-269-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKWAY SURGERY CENTER, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-09",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "BOON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OFFICER / AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "480-567-0269"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NV",
            "license": "2147ASC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0046-02011",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "10-6133",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NV1692",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490004254",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Parkway Surgery Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Parkway Surgery Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Parkway Community Healthcare LLC
• Parkway Imaging Center LLC
• Parkway Imaging Center, LLC
• Parkway Recovery Care Center, LLC
• Parkway Surgery Center, LLC
• Dorothy R Parriott, PHD
• Tracy Parris
• Stacy Ann Parrish
• Clarence E Parrott, LCSW
• Andrea Parry, MS-SLP

• Ambulatory Surgical Clinic/Center in Henderson, NV
• Providers in Henderson, NV by specialty
• Ambulatory Surgical Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.