Surgical Interventions, LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

34005969R Issued in OH

Legal business name

SURGICAL INTERVENTIONS, LLC

Practice address

1371 W Main St
Newark, OH 43055-3681

Phone

(220) 564-1985

Fax

(220) 564-1991

NPI assigned

Jun 21, 2007

Organization subpart

No

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

Authorized official

Name

Robin K Roback

Title

Office Manager

Phone

(220) 564-1985

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576108800000",
    "number": "1497951149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 W MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430553681",
            "telephone_number": "220-564-1985",
            "fax_number": "220-564-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 W MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430553681",
            "telephone_number": "220-564-1985",
            "fax_number": "220-564-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL INTERVENTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A",
        "authorized_official_last_name": "ROBACK",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "220-564-1985"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "OH",
            "license": "34005969R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.