Green Valley Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

GREEN VALLEY SURGERY CENTER LLC

Practice address

7365 S Pecos Rd
Las Vegas, NV 89120-3768

Phone

(702) 857-6500

Fax

(702) 857-6501

NPI assigned

Apr 10, 2017

Organization subpart

No

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

Authorized official

Name

Amy Grim

Title

Credentialing Specialist

Phone

(702) 202-4776

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Listed as

Green Valley Surgery CenterCCN 29C0001119

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Darrick William Neibaur, D.O.

  • Ophthalmology Physician
  • Henderson, NV
  • NPI 1134375918
  NPD (past)

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680048000000",
    "number": "1487187076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S STEPHANIE ST STE 101",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890125731",
            "telephone_number": "702-202-4776",
            "fax_number": "702-202-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7365 S PECOS RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891203768",
            "telephone_number": "702-857-6500",
            "fax_number": "702-857-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN VALLEY SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-10",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A",
        "authorized_official_last_name": "GRIM",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "702-202-4776"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Green Adult Day Care Center,LLC
• Green Desert Dialysis LLC
• Tracy Green Kiper
• Green Valley Anesthesia Services
• Green Valley Home Health LLC
• Jaylen Keysaun Green Wilson
• Markida Sharee Green-Brown, LPN
• Jacqueline Green-Ingram
• Victoria Green-Jobe, M.A.
• Alexander David Green

• Ambulatory Surgical Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Ambulatory Surgical Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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.