NPIMap

Organization Active NPI

Southwest Minnesota Surgical Center, Inc.

  • Ambulatory Surgical Clinic/Center
  • Marshall, MN
National Provider Identifier
1407023161
Registry record updated Feb 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SOUTHWEST MINNESOTA SURGICAL CENTER, INC.
Practice address
1401 Nwakama St
Suite 400
Marshall, MN 56258
Phone
(507) 929-7696
Fax
(507) 393-7697
NPI assigned
May 13, 2008
Last updated
Feb 7, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2018

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

Authorized official

Name
Anthony C NwakamaNPI 1588778658
Title
MD/Owner
Phone
(507) 929-7696

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1401 Nwakama St
Suite 400
Marshall, MN 56258

Mailing address

1401 Nwakama St Ste 400
Marshall, MN 56258-5533
Phone (507) 929-7696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080723000290 MN Part B Supplier - Ambulatory Surgical Center 6305919408 Receives reassigned benefits from 9 practitioners
Practice locations: Marshall, MN

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Southwest Minnesota Surgical Center IncCCN 24C0001069
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D1099030Southwest Minnesota Surgical Center1401 Nwakama Street, Suite 400, Marshall, MN 56258Certificate of waiverMay 3, 2027

National Provider Directory

National Provider Directory

Locations

1401 Nwakama St
Ste 400
Marshall, MN 56258
Phone (507) 929-7696

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517961600000",
    "number": "1407023161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 NWAKAMA ST STE 400",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562585533",
            "telephone_number": "507-929-7696",
            "fax_number": "507-337-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 NWAKAMA ST",
            "address_2": "SUITE 400",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "56258",
            "telephone_number": "507-929-7696",
            "fax_number": "507-393-7697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST MINNESOTA SURGICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-13",
        "last_updated": "2018-02-07",
        "status": "A",
        "authorized_official_last_name": "NWAKAMA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "507-929-7696"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshall, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2018; 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.