Surgical Center of Greensboro LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

AS0018 Issued in NC

Legal business name

SURGICAL CENTER OF GREENSBORO LLC

Practice address

705 Green Valley Rd
Greensboro, NC 27408-7019

Phone

(336) 272-0012

Fax

(336) 544-2150

NPI assigned

Oct 20, 2016

Organization subpart

No

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

Authorized official

Name

Jennifer Graham

Title

Chief Administrative Officer

Phone

(336) 272-0012

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Surgical Center of Greensboro LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Surgical Center of Greensboro LLC

  • Ambulatory Surgical Clinic/Center
  • Greensboro, NC
  • NPI 1033660451
  NPD tax ID
• Surgical Center of Greensboro, LLC

  • Ambulatory Surgical Clinic/Center
  • Greensboro, NC
  • NPI 1245288257
  NPD tax ID

Locations

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548288000000",
    "number": "1407307820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 GREEN VALLEY RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087019",
            "telephone_number": "336-272-0012",
            "fax_number": "336-544-2150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 GREEN VALLEY RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087019",
            "telephone_number": "336-272-0012",
            "fax_number": "336-544-2150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1211 Virginia St",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274011313",
            "country_code": "US",
            "telephone_number": "336-272-0012 x5281",
            "fax_number": "336-544-2150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SURGICAL CENTER OF GREENSBORO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-20",
        "last_updated": "2019-01-24",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "336-272-0012"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NC",
            "license": "AS0018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409923",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maisha T Surgeon, M.A.P.C
• Monica A Surgeon, SW
• Sylvia Surgeon
• Surgical Associates of Asheboro, PLLC
• Surgical Center of Greensboro LLC
• Surgical Center of Greensboro, LLC
• Ashley Nicole Susko, RN, MSN, FNP, PMHNP
• Leslie R Susko, RPH
• Lovepriya Suthaharan, MMSC, PA-C
• Dylan Joseph Suttle, M.D.

• Ambulatory Surgical Clinic/Center in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Ambulatory Surgical Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.