Great Falls Clinic Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

9722 Issued in MT

Legal business name

GREAT FALLS CLINIC SURGERY CENTER LLC

Practice address

1509 29TH St S
Great Falls, MT 59405-5363

Phone

(406) 771-3500

Fax

(406) 771-3501

NPI assigned

Aug 2, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Cheryl D Cornwell

Title

Chief Financial Officer

Phone

(406) 216-8057

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 27C0001016

Legal name

GREAT FALLS CLINIC SURGERY CENTER, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jun 29, 1999

Last certification

Mar 24, 2010

Ownership / control type

Proprietary

Facility address

1509 29TH St S
Great Falls, MT 59405

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 2

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

• CMSC, LLC

  dba Great Falls Clinic Hospital

  • General Acute Care Hospital
  • Great Falls, MT
  • NPI 1639109978

  Member Of

  NPD member
• Great Falls Clinic LLC

  • Multi-Specialty Clinic/Center
  • Great Falls, MT
  • NPI 1801897780

  Member Of

  NPD member

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311120000000",
    "number": "1447251327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 29TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055363",
            "telephone_number": "406-771-3500",
            "fax_number": "406-771-3502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 29TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055363",
            "telephone_number": "406-771-3500",
            "fax_number": "406-771-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT FALLS CLINIC SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2011-07-20",
        "status": "A",
        "authorized_official_last_name": "CORNWELL",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "406-216-8057",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MT",
            "license": "9722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0350829",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS (FORMERLY HCFA)",
            "identifier": "27C0001016",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary E Gray, FNP
• Great Falls Care Holdings, LLC (Invigorate Post Acute of Great Falls)
• Great Falls Caring Dentistry
• Great Falls Chiropractic Clinic, P.L.L.C
• Great Falls Clinic LLC
• Great Falls College Montana State University
• Great Falls Counseling
• Great Falls Counseling Assoc.
• Great Falls Dental Associates LLC
• Great Falls Emergency Services

• Ambulatory Surgical Clinic/Center in Great Falls, MT
• Providers in Great Falls, MT by specialty
• Ambulatory Surgical Clinic/Center in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.