Organization Active NPI

West Palm Beach FL Endoscopy ASC LLC

Doing business as Center for Gastrointestinal Endoscopy

  • Ambulatory Surgical Clinic/Center
  • West Palm Beach, FL
National Provider Identifier
1609841261
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
1119 Issued in FL
Legal business name
WEST PALM BEACH FL ENDOSCOPY ASC LLC
Doing business as
Center for Gastrointestinal Endoscopy
Practice address
1117 N Olive Ave
Suite 201
West Palm Beach, FL 33401-3520
Phone
(561) 514-0353
Fax
(561) 514-0236
NPI assigned
Feb 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Mr. Phillip A Clendenin
Title
President of LLC
Phone
(615) 665-1283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 1119 FL Primary

Addresses

Primary practice location

1117 N Olive Ave
Suite 201
West Palm Beach, FL 33401-3520

Mailing address

1117 N Olive Ave
Suite 201
West Palm Beach, FL 33401-3520
Phone (561) 514-0353

Other identifiers 2

IdentifierTypeStateIssuer
P00289060OtherFLRAILROAD MEDICARE
076072200MedicaidFL

Other names 1

  • Center for Gastrointestinal Endoscopy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1140134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1609841261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 N OLIVE AVE",
            "address_2": "SUITE 201",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013520",
            "telephone_number": "561-514-0353",
            "fax_number": "561-514-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 N OLIVE AVE",
            "address_2": "SUITE 201",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013520",
            "telephone_number": "561-514-0353",
            "fax_number": "561-514-0236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST PALM BEACH FL ENDOSCOPY ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-17",
        "last_updated": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "CLENDENIN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT OF LLC",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "1119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00289060",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076072200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Gastrointestinal Endoscopy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.