Ten Mile Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

TEN MILE SURGERY CENTER, LLC

Practice address

875 S Vanguard Way
Meridian, ID 83642-7552

Phone

(208) 960-0870

NPI assigned

Dec 17, 2020

Organization subpart

No

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

Authorized official

Name

Jennifer Bloxham

Title

Administrator

Phone

(208) 302-7960

Specialties & licenses 1

Addresses

Other names 1

• Ten Mile Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Listed as

Saltzer ASC 10 Mile LLCCCN 13C0001089

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

Member of 1

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

• Ihc Health Services Inc.

  • Emergency Medicine Physician
  • Huntsville, UT
  • NPI 1255465142

  Member Of

  NPD member

Locations

Practitioners 1

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

• Jesse Dylan Chlebeck, M.D.

  • Orthopaedic Surgery Physician
  • Nampa, ID
  • NPI 1073879185
  NPD (past)

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747180800000",
    "number": "1689260341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 S VANGUARD WAY STE 120",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428541",
            "telephone_number": "208-302-7960",
            "fax_number": "208-302-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 S VANGUARD WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427552",
            "telephone_number": "208-960-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEN MILE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-17",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A",
        "authorized_official_last_name": "BLOXHAM",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "208-302-7960"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ten Mile Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Corinne Teigen, LMSW
• Lodaicy E Teldeschi
• Telemental Health Link LLC
• Sri Harsha Tella, MBBS
• Ten Mile Smiles Inc
• Aubrie Tenney
• Janessa Tenney, PA-C
• Terrace Home Health Boise LLC
• Terrace Home Health Boise LLC
• Terrace Home Health Boise LLC

• Ambulatory Surgical Clinic/Center in Meridian, ID
• Providers in Meridian, ID by specialty
• Ambulatory Surgical Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; 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.