Coliseum Same Day Surgery Center LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

011-188 Issued in GA

Legal business name

COLISEUM SAME DAY SURGERY CENTER LP

Practice address

340 Hospital Dr
BLDG E
Macon, GA 31217-3838

Phone

(478) 742-1403

Fax

(478) 742-7018

NPI assigned

Jun 24, 2005

Last updated

Aug 24, 2021By 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

Ms. Kay Buxton

Title

Administrator

Phone

(478) 742-1403

Specialties & licenses 1

Addresses

Other identifiers 2

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 1609872597. Details of each certification follow.

• CCN 11C0001007 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 11C0001007

Legal name

COLISEUM SAME DAY SURGERY CENTER, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jul 2, 1985

Last certification

Aug 24, 2017

Ownership / control type

Proprietary

Facility address

340 Hospital Drive, Building E
Macon, GA 31217

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Piedmont Healthcare Inc

  • Cardiovascular Disease Physician
  • Stockbridge, GA
  • NPI 1376624940

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1609872597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6154",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312086154",
            "telephone_number": "478-742-1403",
            "fax_number": "478-742-7018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 HOSPITAL DR",
            "address_2": "BLDG E",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173838",
            "telephone_number": "478-742-1403",
            "fax_number": "478-742-7018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLISEUM SAME DAY SURGERY CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "BUXTON",
        "authorized_official_first_name": "KAY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "478-742-1403",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": "011-188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354263A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCARE PROVIDER",
            "identifier": "490004496",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coliseum Medical Center, LLC (Piedmont Macon Medical Center)
• Coliseum Medical Center, LLC (Piedmont Macon Medical Center)
• Coliseum Park Cancer Treatment Center
• Coliseum Pediatric and Adolescent Care, Inc
• Coliseum Primary Care Services, LLC (Coliseum Medical Group-Northside)
• April Nicole Colley, CPNP
• Collier B. Gladin, Jr., M.D., LLC (Collier B Gladin Jr MD)
• Deborah Lusendia Collier, FNP-C
• Samuel Scott Collier, NP
• Carol Lynn Collings, MD

• Ambulatory Surgical Clinic/Center in Macon, GA
• Providers in Macon, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.