Northern Nevada Ambulatory Surgical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

2048ASC-19 Issued in NV

Legal business name

NORTHERN NEVADA AMBULATORY SURGICAL CENTER LLC

Practice address

5411 Kietzke Lane
Reno, NV 89511

Phone

(775) 954-0600

Fax

(775) 954-0612

NPI assigned

Apr 10, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Stacey Ingram

Title

Administrator

Phone

(775) 954-0600

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Surgical Arts Surgery Center Doing business as

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275436800000",
    "number": "1699738872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5411 KIETZKE LANE",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89511",
            "telephone_number": "775-954-0600",
            "fax_number": "775-954-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5411 KIETZKE LANE",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89511",
            "telephone_number": "775-954-0600",
            "fax_number": "775-954-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN NEVADA AMBULATORY SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2010-06-02",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "775-954-0600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NV",
            "license": "2048ASC-12",
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NV",
            "license": "2048ASC-19",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004616009",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgical Arts Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Reno, NV
• Providers in Reno, NV by specialty
• Ambulatory Surgical Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; 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.