The Associates of Memorial Mission Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

147 Issued in TN

Legal business name

THE ASSOCIATES OF MEMORIAL MISSION SURGERY CENTER, LLC

Practice address

2515 Desales Ave
Chattanooga, TN 37404-1100

Phone

(423) 648-6672

Fax

(423) 648-5312

NPI assigned

Feb 27, 2006

Last updated

Mar 12, 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

Dr. Alan Shikoh, MD

Title

Chairman of the Board

Phone

(423) 648-6672

Specialties & licenses 1

Addresses

Other identifiers 3

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Chattanooga Orthopaedic Group, PC

  dba Center for Sports Medicine and Orthopaedics

  • Orthopaedic Surgery Physician
  • Chattanooga, TN
  • NPI 1437510393

  Member Of

  NPD member
• Memorial Health Care System Inc.

  dba Memorial Hospital

  • General Acute Care Hospital
  • Chattanooga, TN
  • NPI 1255428736

  Member Of

  NPD member

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.

• Brett Stanford Sanders, MD

  • Orthopaedic Hand Surgery Physician
  • Chattanooga, TN
  • NPI 1427048073
  NPD (past)

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236816000000",
    "number": "1740256197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23785",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374223785",
            "telephone_number": "423-648-6672",
            "fax_number": "423-648-5312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 DESALES AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041100",
            "telephone_number": "423-648-6672",
            "fax_number": "423-648-5312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ASSOCIATES OF MEMORIAL MISSION SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-27",
        "last_updated": "2009-03-12",
        "status": "A",
        "authorized_official_last_name": "SHIKOH",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "CHAIRMAN OF THE BOARD",
        "authorized_official_telephone_number": "423-648-6672",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261507535A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3288753",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "4053703",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christie Rose Thacker, FNP-BC
• Courtney Thacker, BCBA
• The a I M Center, Inc.
• The Allergy & Asthma Group P.C.
• The Arc of Hamilton County
• The Beauty Bar
• The Center for Pulmonary & Sleep Disorders,PLLC (CPSD,PLLC)
• The Chattanooga Spine and Wellness Institute, Inc (Southeast Center for Bone and Joint)
• The Dalton Clinic of Chiropractic Inc.
• The Derm Center, PLLC

• Ambulatory Surgical Clinic/Center in Chattanooga, TN
• Providers in Chattanooga, 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 Mar 12, 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.