Center for Advanced Laparoscopic and Bariatric Surgery, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

04046774A Issued in IN

Legal business name

CENTER FOR ADVANCED LAPAROSCOPIC AND BARIATRIC SURGERY, LLC

Practice address

506 W 2ND St
Bloomington, IN 47403-2316

Phone

(812) 961-0370

Fax

(812) 330-9962

NPI assigned

Sep 19, 2007

Organization subpart

No

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

Authorized official

Name

James Bradley Ray, MD

Title

President

Phone

(812) 330-9962

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447027200000",
    "number": "1447446992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 W 2ND ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032316",
            "telephone_number": "812-330-9962",
            "fax_number": "812-330-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 W 2ND ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032316",
            "telephone_number": "812-961-0370",
            "fax_number": "812-330-9962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR ADVANCED LAPAROSCOPIC AND BARIATRIC SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2015-11-09",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-330-9962",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IN",
            "license": "04046774A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Ambulatory Surgical Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; 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.