NPIMap

Organization Active NPI

Southpoint Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1477500767
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SOUTHPOINT SURGERY CENTER, LLC
Practice address
7051 Southpoint Parkway
Jacksonville, FL 32206-0911
Phone
(904) 854-4854
Fax
(904) 398-6408
NPI assigned
May 30, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ernst Nicolitz, M.D.NPI 1275512394
Title
Medical Director
Phone
(904) 854-4854

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 FL Primary

Addresses

Primary practice location

7051 Southpoint Parkway
Jacksonville, FL 32206-0911

Mailing address

PO Box 10908
Jacksonville, FL 32247-0908
Phone (904) 854-4854

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070105000106 FL Part B Supplier - Ambulatory Surgical Center 3971503509 Practice locations: Jacksonville, FL

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Southpoint Surgery Center LLCCCN 10C0001479
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477500767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10908",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322470908",
            "telephone_number": "904-854-4854",
            "fax_number": "904-398-6408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7051 SOUTHPOINT PARKWAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322060911",
            "telephone_number": "904-854-4854",
            "fax_number": "904-398-6408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHPOINT SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NICOLITZ",
        "authorized_official_first_name": "ERNST",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "904-854-4854",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.