Organization Active NPI

Mercy Ambulatory Surgery Center LTD

  • Ambulatory Surgical Clinic/Center
  • Fairfield, OH
National Provider Identifier
1558327445
Registry record updated Aug 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
173 Issued in OH
Legal business name
MERCY AMBULATORY SURGERY CENTER LTD
Practice address
2990 Mack Rd
Fairfield, OH 45014-5383
Phone
(513) 874-6440
NPI assigned
Apr 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2007

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

Authorized official

Name
Kimberly Wood
Title
Director
Phone
(828) 236-3027

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 173 OH Primary

Addresses

Primary practice location

2990 Mack Rd
Fairfield, OH 45014-5383

Mailing address

2990 Mack Rd
Fairfield, OH 45014-5383
Phone (513) 874-6440

Other identifiers 1

IdentifierTypeStateIssuer
0573928MedicaidOH

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188518400000",
    "number": "1558327445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 MACK RD",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145383",
            "telephone_number": "513-874-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 MACK RD",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145383",
            "telephone_number": "513-874-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY AMBULATORY SURGERY CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2007-08-31",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "828-236-3027"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OH",
            "license": "173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0573928",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.