Campbell Clinic Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CAMPBELL CLINIC SURGERY CENTER, LLC

Practice address

7887 Wolf River Blvd
Germantown, TN 38138-1718

Phone

(901) 759-5464

Fax

(901) 759-5476

NPI assigned

Jul 26, 2006

Organization subpart

No

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

Authorized official

Name

Tiffany D Monk, RN, BSN, CASC

Title

Administrator

Phone

(901) 759-5454

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Listed as

Campbell Clinic Surgery Center LLCCCN 44C0001117

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 organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Tier 1 Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Cookeville, TN
  • NPI 1326838004

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1720001928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7887 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381718",
            "telephone_number": "901-759-5464",
            "fax_number": "901-759-5476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7887 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381718",
            "telephone_number": "901-759-5464",
            "fax_number": "901-759-5476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 S Pauline St",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381043221",
            "country_code": "US",
            "telephone_number": "901-261-2805",
            "fax_number": "901-261-2809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAMPBELL CLINIC SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "MONK",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "901-759-5454",
        "authorized_official_credential": "RN, BSN, CASC"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Ralph Callihan, MD
• Dawson Brianna Callonas, ATC, LAT
• Campbell Clinic
• Campbell Clinic PC
• Campbell Clinic PC
• Campbell Clinic, PC
• Angela Campbell
• Jasmine Elyse Campbell, APRN
• Kimberly Campbell
• Chad Campion, M.D,

• Ambulatory Surgical Clinic/Center in Germantown, TN
• Providers in Germantown, TN by specialty
• Ambulatory Surgical Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.