Fayetteville Ambulatory Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

FAYETTEVILLE AMBULATORY SURGERY CENTER LLC

Doing business as

Fayetteville Ambulatory Surgery Center

Practice address

1781 Metromedical Dr
Fayetteville, NC 28304-3862

Phone

(910) 323-1647

Fax

(910) 615-9950

NPI assigned

Apr 27, 2006

Last updated

Nov 22, 2024By 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

Christopher Joseph Meredith

Title

Corporate Director

Phone

(910) 609-3212

Specialties & licenses 1

Addresses

Other names 1

• Fayetteville Ambulatory Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Listed as

Fayetteville ASC Sca AffiliateCCN 34C0001004

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.

• Cumberland County Hospital System Inc

  dba Cape Fear Valley Palliative Care

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Fayetteville, NC
  • NPI 1316486640

  Member Of

  NPD member

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732233600000",
    "number": "1700843208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1781 METROMEDICAL DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1781 METROMEDICAL DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043862",
            "telephone_number": "910-323-1647",
            "fax_number": "910-615-9950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTEVILLE AMBULATORY SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A",
        "authorized_official_last_name": "MEREDITH",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CORPORATE DIRECTOR",
        "authorized_official_telephone_number": "910-609-3212"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fayetteville Ambulatory Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Fayetteville Area Health Education Foundation Inc (Southern Regional Area Health Education Center)
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• Fayetteville Associates in Laboratory Medicine
• Fayetteville Breastfeeding Center Inc

• Ambulatory Surgical Clinic/Center in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Ambulatory Surgical Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.