Surgical Specialists P C

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD12630 Issued in TN

Legal business name

SURGICAL SPECIALISTS P C

Practice address

143 Kennedy Dr
Suite B
Martin, TN 38237-3309

Phone

(731) 587-3030

NPI assigned

Jun 18, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Egbert Rebeiro, M.DNPI 1275583908

Title

President

Phone

(731) 587-3030

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN, AR2 enrollments

Enrollment records 2

Locations

Practitioners 3

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

• Egbert Rebeiro, M.D.

  • Surgery Physician
  • Martin, TN
  • NPI 1275583908

  AR

  Medicare reassignment NPD Authorized official
• Angela B Cursey, NURSE PRACT

  • Nurse Practitioner
  • Martin, TN
  • NPI 1912007469
  NPD (past)
• Amiee Foley Stooksberry, APRN

  • Nurse Practitioner
  • Martin, TN
  • NPI 1992919096
  NPD (past)

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1497790091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 KENNEDY DR",
            "address_2": "SUITE B",
            "city": "MARTIN",
            "state": "TN",
            "postal_code": "382373309",
            "telephone_number": "731-587-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 KENNEDY DR",
            "address_2": "SUITE B",
            "city": "MARTIN",
            "state": "TN",
            "postal_code": "382373309",
            "telephone_number": "731-587-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL SPECIALISTS P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "REBEIRO",
        "authorized_official_first_name": "EGBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "731-587-3030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD12630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3727249",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "4092729",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick Michael Stooksberry, D.D.S.
• Haley Sullivan, ATC, LAT
• Carla Rosanne Summers, LPN
• Amanda Supeck, OTR/ L
• Surgical Associates of Martin PC
• Cynthia Raines Swaim, M.D.
• Michael Gregg Swaim, DPH
• Ronnell Van Swaim, DPH
• Jennifer Dawn Sweatt, LPN
• T.N.L. Transportation Co., Inc

• Surgery Physician in Martin, TN
• Providers in Martin, TN by specialty
• Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.