Advanced Ambulatory Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ADVANCED AMBULATORY SURGERY CENTER LLC

Practice address

4695 E 37TH St N
Wichita, KS 67220

Phone

(316) 942-4519

NPI assigned

Oct 28, 2021

Last updated

Aug 23, 2023By 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

Jon Parks, MDNPI 1477544658

Title

Owner

Phone

(316) 942-4519

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Listed as

Advanced Ambulatory Surgery Center LLCCCN 17C0001900

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

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.

• Jon Charles Parks, MD

  • Pain Medicine Physician
  • Wichita, KS
  • NPI 1477544658
  NPD Authorized official

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692748800000",
    "number": "1740944487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4695 E 37TH ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672203208",
            "telephone_number": "316-260-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4695 E 37TH ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67220",
            "telephone_number": "316-942-4519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED AMBULATORY SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-28",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-942-4519",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Wichita, KS
• Providers in Wichita, KS by specialty
• Ambulatory Surgical Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.