Pma Surgery Center LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

PMA SURGERY CENTER LLC

Practice address

101 Med Tech Pkwy
Suite 205
Johnson City, TN 37604-4007

Phone

(423) 232-9420

Fax

(423) 232-9425

NPI assigned

Jul 2, 2008

Organization subpart

No

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

Authorized official

Name

William Turney Williams, MD

Title

Medical Director

Phone

(423) 232-6120

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Pma Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Johnson City, TN
  • NPI 1720024284

  O20050203000978

  Same enrollment

Tax ID family

Pma Surgery Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pma Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Johnson City, TN
  • NPI 1720024284
  NPD tax ID

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1548422355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MED TECH PKWY",
            "address_2": "SUITE 205",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376044007",
            "telephone_number": "423-232-9420",
            "fax_number": "423-232-9425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MED TECH PKWY",
            "address_2": "SUITE 205",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376044007",
            "telephone_number": "423-232-9420",
            "fax_number": "423-232-9425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PMA SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TURNEY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "423-232-6120",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP TENNCARE",
            "identifier": "100048318",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007949702",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3288982",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARITEN",
            "identifier": "702040581",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "604059200",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00188946",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE OF THE NEW RIVER VALLEY",
            "identifier": "TN010",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4097786",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Player, P.T., D.P.T.
• Donna Ann Pleasant, RN
• Rita Elizabeth Treanor Plemmons Winfield, MD
• Aria Noel Pless, PA-C
• Amber C Ploucha, NP-C
• Pma Surgery Center, LLC
• Podiatric Clinics of Northeast TN
• David Ernest Poe, DMD
• Allison Poget, DDS
• Phillippe A Poget, PT

• Psychologist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.