Colton Ca Multi ASC LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

COLTON CA MULTI ASC LP

Practice address

1003 E Brier Drive
Suite 170
San Bernardino, CA 92408-2862

Phone

(909) 370-2190

Fax

(909) 370-2266

NPI assigned

Nov 29, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Jeffery Snodgrass

Title

President

Phone

(615) 665-1283

Specialties & licenses 1

Addresses

Other names 1

• Premier Outpatient Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Premier Outpatient Surgery CenterCCN 05C0001516

Medicare certification status

ActiveFrom the Provider of Services file

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": "1354147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674172800000",
    "number": "1629313739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD.",
            "address_2": "LICENSURE AND CERT DEPT",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156187",
            "telephone_number": "615-263-4011",
            "fax_number": "615-234-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 E BRIER DRIVE",
            "address_2": "SUITE 170",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082862",
            "telephone_number": "909-370-2190",
            "fax_number": "909-370-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLTON CA MULTI ASC LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-29",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A",
        "authorized_official_last_name": "SNODGRASS",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Outpatient Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier Outpatient Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexa Nicole Collas
• Arin Vanessa Collin, MD
• Candice Collins
• Marissa Lauren Collins
• Marlon Rashaad Collins
• Christian Alexander Colunga
• Comfort Home Healthcare Services LLC
• Community Action Partnership of San Bernardino County
• Community Care Mobile Doctors
• Community Health Care Foundation

• All providers in San Bernardino, CA
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.