Emerald Surgical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

EMERALD SURGICAL CENTER LLC

Practice address

811 N Liberty St
Boise, ID 83704-8703

Phone

(208) 323-4522

NPI assigned

Dec 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kerry W. Anderson, DPM

Title

MGN. Partner

Phone

(208) 323-4522

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Listed as

Emerald Surgical Center LLCCCN 13C0001017

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": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376607309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 N LIBERTY ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048703",
            "telephone_number": "208-323-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 N LIBERTY ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048703",
            "telephone_number": "208-323-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "KERRY",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "MGN. PARTNER",
        "authorized_official_telephone_number": "208-323-4522",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Kay Embury, OTR/L
• Victoria Emenari, DOCTOR OF PHARMACY
• Emerald Medical Investors, LLC
• Emerald Optics LLC
• Emerald Smiles Dentistry, PC
• Emerald West Family Dentistry
• Emergency Responders Health Center, LLC
• Emeritus Corporation
• Jeni T Emerizy, LMSW
• Travis Emerizy, LMSW

• Ambulatory Surgical Clinic/Center in Boise, ID
• Providers in Boise, ID by specialty
• Ambulatory Surgical Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.