Healthcrest Surgical Management, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

HEALTHCREST SURGICAL MANAGEMENT, LLC

Practice address

3540 S Boulevard Ste 225
Edmond, OK 73013-5569

Phone

(405) 697-2420

Fax

(405) 697-2470

NPI assigned

Jul 14, 2021

Organization subpart

No

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

Authorized official

Name

Trisha Grus

Title

VP, Managed Care Contracting

Phone

(405) 697-2420

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626220800000",
    "number": "1659943157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 S BOULEVARD STE 225",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135569",
            "telephone_number": "405-697-2420",
            "fax_number": "405-697-2470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 S BOULEVARD STE 225",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135569",
            "telephone_number": "405-697-2420",
            "fax_number": "405-697-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHCREST SURGICAL MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A",
        "authorized_official_last_name": "GRUS",
        "authorized_official_first_name": "TRISHA",
        "authorized_official_title_or_position": "VP, MANAGED CARE CONTRACTING",
        "authorized_official_telephone_number": "405-697-2420"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Edmond, OK
• Providers in Edmond, OK by specialty
• Ambulatory Surgical Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.