NPIMap

Organization Active NPI

Urosurg, LLC

  • Ambulatory Surgical Clinic/Center
  • Tifton, GA
National Provider Identifier
1407106933
Registry record updated Sep 12, 2012
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Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
UROSURG, LLC
Practice address
1815 Old Ocilla Rd
Tifton, GA 31794-1617
Phone
(229) 391-3535
Fax
(229) 391-3529
NPI assigned
Sep 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Authorized official

Name
Miss Jennifer D Flowers
Title
ASC Administrator
Phone
(229) 391-3541

Specialties & licenses 1

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

Addresses

Primary practice location

1815 Old Ocilla Rd
Tifton, GA 31794-1617

Mailing address

1815 Old Ocilla Rd
Tifton, GA 31794-1617
Phone (229) 391-3535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 11C0001394

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
UROSURG, LLC
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Nov 5, 2012
Last certification
Nov 5, 2012
Ownership / control type
Proprietary
Facility address
1815 Old Ocilla Road
Tifton, GA 31794

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347408000000",
    "number": "1407106933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 OLD OCILLA RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941617",
            "telephone_number": "229-391-3535",
            "fax_number": "229-391-3529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 OLD OCILLA RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941617",
            "telephone_number": "229-391-3535",
            "fax_number": "229-391-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROSURG, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-12",
        "last_updated": "2012-09-12",
        "status": "A",
        "authorized_official_last_name": "FLOWERS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ASC ADMINISTRATOR",
        "authorized_official_telephone_number": "229-391-3541",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

Verify at the official NPI Registry.