Springdale Bentonville Surgery Center LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

AR4278 Issued in AR

Legal business name

SPRINGDALE BENTONVILLE SURGERY CENTER LP

Doing business as

Northwest Ambulatory Surgery Center - Springdale

Practice address

601 W Maple Ave
Suite 302
Springdale, AR 72764-5335

Phone

(479) 750-5800

Fax

(479) 685-7262

NPI assigned

May 17, 2006

Last updated

Feb 3, 2009By 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

Laurie Holtsford

Title

Director, Business Office Support

Phone

(615) 465-7466

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Northwest Ambulatory Surgery Center - Springdale Doing business as

Tax ID family

Northwest Ambulatory Surgery Center - Bentonville2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Springdale Bentonville Surgery Center LP

  dba Northwest Ambulatory Surgery Center - Bentonville

  • Ambulatory Surgical Clinic/Center
  • Bentonville, AR
  • NPI 1750333795
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rex Dwayne Waggoner, CRNA

  • Certified Registered Nurse Anesthetist
  • Springdale, AR
  • NPI 1790769164
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233619200000",
    "number": "1730131731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 842494",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752842494",
            "telephone_number": "479-750-5800",
            "fax_number": "479-685-7262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W MAPLE AVE",
            "address_2": "SUITE 302",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727645335",
            "telephone_number": "479-750-5800",
            "fax_number": "479-685-7262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGDALE BENTONVILLE SURGERY CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2009-02-03",
        "status": "A",
        "authorized_official_last_name": "HOLTSFORD",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "DIRECTOR, BUSINESS OFFICE SUPPORT",
        "authorized_official_telephone_number": "615-465-7466"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AR",
            "license": "AR4278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158419128",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Ambulatory Surgery Center - Springdale",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Miranda Renea Sprenger
• Sprindale Ar Caregiving LLC (Cornerstone Caregiving LLC)
• Spring Dental Springdale (River Dental Springdale)
• Spring of Renewal
• Springdale Ar Caregiving LLC (Cornerstone Caregiving)
• Springdale Emergency Group LLC
• Springdale Foot Specialist PA
• Springdale Health
• Springdale Home Care Services LLC (Access Home Health)
• Springdale Public Schools

• Ambulatory Surgical Clinic/Center in Springdale, AR
• Providers in Springdale, AR by specialty
• Ambulatory Surgical Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.