NPIMap

Organization Active NPI

Physicians Surgery Center Anesthesia

  • Ambulatory Surgical Clinic/Center
  • Carbondale, IL
National Provider Identifier
1699052621
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
7003128 Issued in IL
Legal business name
PHYSICIANS SURGERY CENTER ANESTHESIA
Practice address
2601 W Main St
Carbondale, IL 62901-1031
Phone
(618) 549-5361
NPI assigned
Nov 4, 2011
Organization subpart
Yes
Parent organization
PHYSICIANS SURGERY CENTER LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

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

Authorized official

Name
Phillip L Schaefer
Title
Board Member
Phone
(618) 549-5361

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 7003128 IL Primary

Addresses

Primary practice location

2601 W Main St
Carbondale, IL 62901-1031

Mailing address

2601 W Main St
Carbondale, IL 62901-1031

National Provider Directory

National Provider Directory
Tax ID family
Physicians Surgery Center LLC2 organizations share this tax ID, including this one
Part of
Physicians Surgery Center LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1320364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320364800000",
    "number": "1699052621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 W MAIN ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 W MAIN ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011031",
            "telephone_number": "618-549-5361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS SURGERY CENTER ANESTHESIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHYSICIANS SURGERY CENTER LLC",
        "enumeration_date": "2011-11-04",
        "last_updated": "2011-11-04",
        "status": "A",
        "authorized_official_last_name": "SCHAEFER",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BOARD MEMBER",
        "authorized_official_telephone_number": "618-549-5361"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "7003128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; 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.