Walnut Hill Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

WALNUT HILL SURGERY CENTER, LLC

Practice address

5494 Glen Lakes Dr
Dallas, TX 75231-4308

Phone

(214) 692-6220

Fax

(214) 696-1579

NPI assigned

May 16, 2006

Organization subpart

No

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

Authorized official

Name

Ryan Nicks

Title

Cfo

Phone

(720) 524-1001

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Walnut Hill Surgery CenterCCN 45C0001352

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

Locations

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572307200000",
    "number": "1700838190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 E MEXICO AVE STE 102",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802103941",
            "telephone_number": "303-800-2078",
            "fax_number": "303-800-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5494 GLEN LAKES DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314308",
            "telephone_number": "214-692-6220",
            "fax_number": "214-696-1579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT HILL SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2019-10-29",
        "status": "A",
        "authorized_official_last_name": "NICKS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "720-524-1001"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "TX",
            "license": "008040",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165322201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walnut Hill Chiropractic Clinic, Inc.
• Walnut Hill ENT PLLC
• Walnut Hill Obstetrics & Gynecology Associates
• Walnut Hill Optical
• Walnut Hill Physicians Hospital, LLC
• Matthew Eric Walser, MD
• Amy Atendido Walsh
• Carol Walsh, LPC
• Christian Walsh, LPC ASSOCIATE
• Connor Jared Walsh, PHARMD

• Ambulatory Surgical Clinic/Center in Dallas, TX
• Providers in Dallas, 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 Oct 29, 2019; 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.