Organization Active NPI

Wilmington Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Wilmington, OH
National Provider Identifier
1609014034
Registry record updated Jan 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
WILMINGTON SURGERY CENTER
Practice address
721 W Main St
Wilmington, OH 45177-2126
Phone
(937) 382-7724
Fax
(937) 382-7726
NPI assigned
Jan 22, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2009

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

Authorized official

Name
Dr. Terry Schultz, OD
Title
Clinical Director
Phone
(866) 587-8790

Specialties & licenses 1

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

Addresses

Primary practice location

721 W Main St
Wilmington, OH 45177-2126

Mailing address

50 N Plaza Blvd
Chillicothe, OH 45601-1757
Phone (866) 587-8790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100726000021 OH Part B Supplier - Ambulatory Surgical Center 5496887531 Practice locations: Wilmington, OH

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Wilmington Surgery CenterCCN 36C0001258
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D1095438Wilmington Surgery Center721 West Main Street, Wilmington, OH 45177Certificate of waiverFeb 8, 2027

National Provider Directory

National Provider Directory

Locations

721 W Main St
Wilmington, OH 45177
Phone (937) 382-7724

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232582400000",
    "number": "1609014034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N PLAZA BLVD",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456011757",
            "telephone_number": "866-587-8790",
            "fax_number": "740-774-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 W MAIN ST",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772126",
            "telephone_number": "937-382-7724",
            "fax_number": "937-382-7726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILMINGTON SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-22",
        "last_updated": "2009-01-22",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "866-587-8790",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.