Clarksville Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0000000095 Issued in TN

Legal business name

CLARKSVILLE SURGERY CENTER LLC

Practice address

793 Weatherly Dr
Clarksville, TN 37043-8942

Phone

(931) 542-2915

Fax

(931) 648-1816

NPI assigned

Jun 6, 2006

Organization subpart

No

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

Authorized official

Name

Scott Montgomery

Title

Authorized Official

Phone

(931) 645-1373

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Listed as

Clarksville Surgery Center LLCCCN 44C0001087

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

Member of 3

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

• Saint Thomas Health

  dba Ascension Rx 1206

  • Community/Retail Pharmacy
  • Centerville, TN
  • NPI 1225550031

  Member Of

  NPD member
• Baylor University Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Dallas, TX
  • NPI 1518967231

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  dba Baptist Health System

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

Practitioners 1

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.

• John L Stanton, M.D.

  • Orthopaedic Surgery Physician
  • Clarksville, TN
  • NPI 1245233063
  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767657600000",
    "number": "1487693123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "793 WEATHERLY DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438942",
            "telephone_number": "931-542-2915",
            "fax_number": "931-648-1816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "793 WEATHERLY DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438942",
            "telephone_number": "931-542-2915",
            "fax_number": "931-648-1816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSVILLE SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "931-645-1373"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "0000000095",
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "TN",
            "license": "0000000095",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3119020",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3119020",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Clarksville Residential, LLC (Dogwood Bend Assisted Living)
• Clarksville Sleepdisorders Center
• Clarksville SNF Healthcare,LLC (Park Meadows Post Acute)
• Clarksville Spine and Wellness
• Clarksville Sportsmed & Wellness
• Clarksville Surgical Associates, PLC
• Clarksville Surgicenter, LLC
• Clarksville Therapy Professionals, LLC.
• Clarksville Tongue Tie Center PLLC
• Clarksville Treatment Center, LLC (Clarksville Comprehensive Treatment Center)

• Ambulatory Surgical Clinic/Center in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Ambulatory Surgical Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2026; 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.