Organization Active NPI

Plaza Surgery, G.P.

  • Ambulatory Surgical Clinic/Center
  • Chattanooga, TN
National Provider Identifier
1497750400
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
0000000135 Issued in TN
Legal business name
PLAZA SURGERY, G.P.
Practice address
979 E 3Rd St
Chattanooga, TN 37403-2136
Phone
(423) 778-3192
Fax
(423) 778-2164
NPI assigned
Jun 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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

Authorized official

Name
Ms. Dawn Hurst
Title
Business Office Manager
Phone
(423) 778-3192

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 0000000135 TN Primary

Addresses

Primary practice location

979 E 3Rd St
Chattanooga, TN 37403-2136

Mailing address

13740 Cypress Terrace Cir
Ste 501-503
Fort Myers, FL 33907-8827
Phone (239) 274-1000

Other identifiers 3

IdentifierTypeStateIssuer
3288588MedicaidTN
6800041OtherUNITED HEALTHCARE
4015206OtherTNBC/BS OF TN

National Provider Directory

National Provider Directory

Locations

979 E 3rd St
Ste G25
Chattanooga, TN 37403
Phone (423) 778-3192

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1497750400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13740 CYPRESS TERRACE CIR",
            "address_2": "STE 501-503",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339078827",
            "telephone_number": "239-274-1000",
            "fax_number": "239-274-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "979 E 3RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032136",
            "telephone_number": "423-778-3192",
            "fax_number": "423-778-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAZA SURGERY, G.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "HURST",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "423-778-3192",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "0000000135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3288588",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "6800041",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF TN",
            "identifier": "4015206",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; 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.