Organization Active NPI

Mid Missouri Surgery Center, LLC

Doing business as Surgery Center at The Forum

  • Ambulatory Surgical Clinic/Center
  • Columbia, MO
National Provider Identifier
1760860977
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
MID MISSOURI SURGERY CENTER, LLC
Doing business as
Surgery Center at The Forum
Practice address
1410 Forum Katy Parkway
Suite 102
Columbia, MO 65203
Phone
(573) 441-7070
NPI assigned
May 8, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Authorized official

Name
Mrs. Christy Lee, RN
Title
Administrator
Phone
(573) 441-7070

Specialties & licenses 1

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

Addresses

Primary practice location

1410 Forum Katy Parkway
Suite 102
Columbia, MO 65203

Mailing address

1410 Forum Katy Parkway
Suite 102
Columbia, MO 65203
Phone (573) 441-7070

Other names 1

  • Surgery Center at The Forum Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151228000457 MO Part B Supplier - Ambulatory Surgical Center 4789985359 Practice locations: Columbia, MO

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Mid Missouri Surgery Center LLCCCN 26C0001152
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
26D2098394Mid Missouri Surgery Center LLC1410 Forum Katy Parkway Suite 102, Columbia, MO 65203Certificate of waiverJul 6, 2027

National Provider Directory

National Provider Directory

Locations

1410 Forum Katy Pkwy
Ste 1
Columbia, MO 65203
Phone (573) 397-6556

1410 Forum Katy Pkwy
Ste 102
Columbia, MO 65203
Phone (573) 397-6556

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750032000000",
    "number": "1760860977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 FORUM KATY PARKWAY",
            "address_2": "SUITE 102",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65203",
            "telephone_number": "573-441-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 FORUM KATY PARKWAY",
            "address_2": "SUITE 102",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65203",
            "telephone_number": "573-441-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID MISSOURI SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-08",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "573-441-7070",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgery Center at The Forum",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; 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.