Organization Active NPI

Paris Surgical Specialists, P.L.L.C.

  • Surgery Physician
  • Paris, TN
National Provider Identifier
1790701654
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
PARIS SURGICAL SPECIALISTS, P.L.L.C.
Practice address
235 Tyson Ave
Paris, TN 38242-4544
Phone
(731) 644-3211
Fax
(731) 644-1552
NPI assigned
Jul 14, 2006
Last updated
Nov 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2007

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

Authorized official

Name
Stacia Lynn Puckett
Title
Office Manager
Phone
(731) 644-3211

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X

Addresses

Primary practice location

235 Tyson Ave
Paris, TN 38242-4544

Mailing address

235 Tyson Ave
Paris, TN 38242-4544
Phone (731) 644-3211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040401000540 TN Part B Supplier - Clinic/Group Practice 3274525092 Receives reassigned benefits from 4 practitioners
Practice locations: Paris, TN; Union City, TN

National Provider Directory

National Provider Directory

Locations

300 Hospital Cir
Ste 300
Paris, TN 38242
Phone (731) 644-3211

1010 Wayne Rd
Ste 204
Savannah, TN 38372
Phone (731) 644-3211

150 Guinn St
Savannah, TN 38372
Phone (731) 644-3211

Practitioners & affiliated clinicians

Practitioners 4

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": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194220800000",
    "number": "1790701654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 TYSON AVE",
            "city": "PARIS",
            "state": "TN",
            "postal_code": "382424544",
            "telephone_number": "731-644-3211",
            "fax_number": "731-644-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 TYSON AVE",
            "city": "PARIS",
            "state": "TN",
            "postal_code": "382424544",
            "telephone_number": "731-644-3211",
            "fax_number": "731-644-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARIS SURGICAL SPECIALISTS, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-11-05",
        "status": "A",
        "authorized_official_last_name": "PUCKETT",
        "authorized_official_first_name": "STACIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "731-644-3211"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paris, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.