Amsurg Northern Kentucky Gi LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

300131 Issued in KY

Legal business name

AMSURG NORTHERN KENTUCKY GI LLC

Doing business as

St. Elizabeth Physicians Endoscopy Center

Practice address

340 Thomas More Pkwy
Suite 160B
Crestview Hills, KY 41017-5100

Phone

(859) 331-6466

Fax

(859) 331-1932

NPI assigned

Feb 8, 2006

Last updated

May 3, 2022By 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

Mr. Jeffrey Snodgrass

Title

President

Phone

(615) 665-1283

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• St. Elizabeth Physicians Endoscopy Center Doing business as

Listed as

St Elizabeth Physicians Endoscopy CenterCCN 18C0001028

Medicare certification status

Terminated Voluntary: merger or closure, Feb 26, 2024From the Provider of Services file

Locations

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651536000000",
    "number": "1801869292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD",
            "address_2": "ATTN: L&C",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156103",
            "telephone_number": "859-331-6466",
            "fax_number": "859-331-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 THOMAS MORE PKWY",
            "address_2": "SUITE 160B",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410175100",
            "telephone_number": "859-331-6466",
            "fax_number": "859-331-1932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMSURG NORTHERN KENTUCKY GI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-08",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A",
        "authorized_official_last_name": "SNODGRASS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "KY",
            "license": "300131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100153030",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2278324",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00883600",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Elizabeth Physicians Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Elizabeth Physicians Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ati Cpap Solutions

• Ambulatory Surgical Clinic/Center in Crestview Hills, KY
• Providers in Crestview Hills, KY by specialty
• Ambulatory Surgical Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.