Lebanon Surgicenter, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LEBANON SURGICENTER, LLC

Doing business as

Lebanon Center for Outpatient Surgery

Practice address

125 Willard Hagan Dr
Lebanon, TN 37090-1023

Phone

(615) 449-1150

Fax

(615) 449-1162

NPI assigned

Dec 15, 2025

Last updated

Sep 10, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David McKnight

Title

VP/Cfo

Phone

(972) 789-2816

Specialties & licenses 1

Addresses

Other names 1

• Lebanon Center for Outpatient Surgery Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598629347. Details of each certification follow.

• CCN 44C0001231 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 44C0001231

Legal name

Lebanon Center for Outpatient Surgery

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

May 19, 2026

Last certification

May 19, 2026

Facility address

125 Willard Hagan Drive
Lebanon, TN 37090

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1765756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788998400000",
    "number": "1598629347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WILLARD HAGAN DR",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370901023",
            "telephone_number": "615-449-1150",
            "fax_number": "615-449-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 WILLARD HAGAN DR",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370901023",
            "telephone_number": "615-449-1150",
            "fax_number": "615-449-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEBANON SURGICENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-15",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A",
        "authorized_official_last_name": "MCKNIGHT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "972-789-2816"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lebanon Center for Outpatient Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Ambulatory Surgical Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.