Organization Active NPI

Pavilion Surgicenter, LLC

  • Ambulatory Surgical Clinic/Center
  • Smyrna, TN
National Provider Identifier
1720566433
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PAVILION SURGICENTER, LLC
Doing business as
Physicians Pavilion Surgery Center
Practice address
545 Stonecrest Pkwy
Smyrna, TN 37167-6804
Phone
(615) 220-3720
NPI assigned
Aug 3, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Authorized official

Name
David McKnight
Title
VP/Cfo
Phone
(972) 789-2816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

545 Stonecrest Pkwy
Smyrna, TN 37167-6804

Mailing address

545 Stonecrest Pkwy
Smyrna, TN 37167-6804
Phone (615) 220-3720

Other names 1

  • Physicians Pavilion Surgery Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181226002332 TN Part B Supplier - Ambulatory Surgical Center 5991040610 Practice locations: Smyrna, TN

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Pavilion Surgicenter LLC Dba Physicians Pavilion Surgery CenterCCN 44C0001054
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0926333Pavilion Surgicenter, LLC545 Stonecrest Parkway, Smyrna, TN 37167Certificate of waiverMar 19, 2027

National Provider Directory

National Provider Directory

Locations

300 Stonecrest Blvd
Ste 210
Smyrna, TN 37167
Phone (615) 459-4441

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1533254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1720566433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 STONECREST PKWY",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676804",
            "telephone_number": "615-220-3720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 STONECREST PKWY",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676804",
            "telephone_number": "615-220-3720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVILION SURGICENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-03",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "MCKNIGHT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "972-789-2816"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians Pavilion Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smyrna, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.