Methodist Mansfield Ambulatory Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

METHODIST MANSFIELD AMBULATORY SURGERY CENTER, LLC

Practice address

252 Matlock Rd Ste 430
Mansfield, TX 76063-6565

Phone

(817) 242-3600

Fax

(817) 242-3601

NPI assigned

Feb 19, 2020

Last updated

Aug 22, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer Boyd Baldock

Title

Officer and Authorized Official

Phone

(615) 234-5954

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Methodist Mansfield Ambulatory Surgery Center LLCCCN 45C0001710

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.

• Methodist Hospitals of Dallas

  dba Methodist Mansfield Medical Center

  • General Acute Care Hospital
  • Mansfield, TX
  • NPI 1689629941

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1700419678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 MATLOCK RD STE 430",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636565",
            "telephone_number": "817-242-3600",
            "fax_number": "817-242-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 MATLOCK RD STE 430",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636565",
            "telephone_number": "817-242-3600",
            "fax_number": "817-242-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST MANSFIELD AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-19",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Ann Merrell, M.S. CCC-SLP
• P'Jay Merrell, DDS
• Merrigood Home Care LLC
• Consuela Metcalf, COTA/L
• Methodist Hospitals of Dallas (Methodist Mansfield Medical Center)
• Methodist-Cdi (RAYUS Radiology)
• Robert Meyer III, DPT
• Zachary Meyer, LCSW
• Yaman MHD Nachaat Al Laham
• Michael L. Thornton, D.O., P.a.

• Ambulatory Surgical Clinic/Center in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.