Skyway Surgery Center. LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

23000358 Issued in CA

Legal business name

SKYWAY SURGERY CENTER. LLC

Practice address

121 Raley Blvd
Chico, CA 95928-8347

Phone

(530) 230-2000

Fax

(530) 898-8142

NPI assigned

Jul 29, 2006

Organization subpart

No

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

Authorized official

Name

Jennifer Baldock

Title

Officer and Authorized Official

Phone

(615) 234-5954

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Skyway Surgery Center LLCCCN 05C0001663

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

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1366456618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 RALEY BLVD",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959288347",
            "telephone_number": "530-230-2000",
            "fax_number": "530-898-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 RALEY BLVD",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959288347",
            "telephone_number": "530-230-2000",
            "fax_number": "530-898-8142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYWAY SURGERY CENTER. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "23000358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01663F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "23000358",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Skypark Walk-in Medical Center
• Skyway House
• Skyway House, Inc. (Skyway House)
• Skyway House, LLC
• Skyway House, LLC
• Marilyn E Slater, NPF
• Rachael Malene Slater, DPT
• Susan Slater
• Sarah Margaret Silver Slayter
• Sleep Diagnostics Labs, Inc. (Sleep Diagnostics)

• Ambulatory Surgical Clinic/Center in Chico, CA
• Providers in Chico, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.