Baptist Germantown Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0000000067 Issued in TN

Legal business name

BAPTIST GERMANTOWN SURGERY CENTER, LLC

Doing business as

Baptist Germantown Surgery Center
OrthoSouth Surgery Center-Germantown

Practice address

2100 Exeter Rd
Suite 101
Germantown, TN 38138-3922

Phone

(901) 757-3400

Fax

(901) 751-2870

NPI assigned

Feb 15, 2006

Last updated

Nov 4, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gregory M Duckett

Title

Sr VP/Clo

Phone

(901) 227-5233

Specialties & licenses 1

Addresses

Other names 2

• Baptist Germantown Surgery Center Doing business as
• OrthoSouth Surgery Center-Germantown Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Listed as

Orthosouth Surgery Center Germantown LLCCCN 44C0001099

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Baptist Memorial Health Services Inc

  dba Baptist Home Medical Equipment

  • Oxygen Equipment & Supplies (DME)
  • Columbus, MS
  • NPI 1306802335

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian Ivan Shwer, D.P.M.

  • Foot Surgery Podiatrist
  • Southaven, MS
  • NPI 1588667414
  NPD (past)

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635984000000",
    "number": "1396719563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 EXETER RD",
            "address_2": "SUITE 101",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383922",
            "telephone_number": "901-757-3400",
            "fax_number": "901-751-2870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 EXETER RD",
            "address_2": "SUITE 101",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383922",
            "telephone_number": "901-757-3400",
            "fax_number": "901-751-2870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST GERMANTOWN SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A",
        "authorized_official_last_name": "DUCKETT",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR VP/CLO",
        "authorized_official_telephone_number": "901-227-5233"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "0000000067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Germantown Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Baptist Germantown Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OrthoSouth Surgery Center-Germantown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Grace Balsam
• Joseph George Baltz Jr., M.D.
• Jugert Bango
• Adrian Banks, APRN
• Toney L Banks, CRNA
• Baptist Memorial Medical Group Inc (BMG Wolf River Pharmacy)
• Baptist Memorial Regional Rehabilitation Services Inc
• Baptist Memorial Regional Rehabilitation Services Inc (Baptist Skilled Rehabilititation Unit-Germantown)
• Baptist Memorial Regional Rehabilitation Services Inc
• Baptist Memorial Rehabilitation Hospital, GP (Baptist Memorial Rehabilitation Hospital)

• 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 Nov 4, 2021; 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.