NPIMap

Organization Active NPI

Skyline Endoscopy Center, L.L.C.

  • Ambulatory Surgical Clinic/Center
  • Jackson, TN
National Provider Identifier
1437373248
Registry record updated Jul 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
0000000194 Issued in TN
Legal business name
SKYLINE ENDOSCOPY CENTER, L.L.C.
Practice address
27 Medical Center Dr
Suite 2
Jackson, TN 38301-3949
Phone
(731) 426-0310
NPI assigned
Apr 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2008

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

Authorized official

Name
Dr. Charles S. Hertz Jr., M.D.NPI 1609828326
Title
Director
Phone
(731) 426-0310

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 0000000194 TN Primary

Addresses

Primary practice location

27 Medical Center Dr
Suite 2
Jackson, TN 38301-3949

Mailing address

27 Medical Center Dr
Suite 2
Jackson, TN 38301-3949
Phone (731) 426-0310

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216339200000",
    "number": "1437373248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 MEDICAL CENTER DR",
            "address_2": "SUITE 2",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013949",
            "telephone_number": "731-426-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 MEDICAL CENTER DR",
            "address_2": "SUITE 2",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013949",
            "telephone_number": "731-426-0310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYLINE ENDOSCOPY CENTER, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2008-07-18",
        "status": "A",
        "authorized_official_last_name": "HERTZ",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "731-426-0310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "0000000194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; 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.