Surgical Weight Loss Clinic PLLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

SURGICAL WEIGHT LOSS CLINIC PLLC

Practice address

3716 Pacific Ave
Suite B
Tacoma, WA 98418-7836

Phone

(253) 472-9850

NPI assigned

Mar 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Samuel Ross Fox, MD

Title

Owner & Surgeon

Phone

(253) 472-9850

Specialties & licenses 3

Addresses

Other identifiers 5

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ann M Failoni, ARNP

  • Adult Health Nurse Practitioner
  • Port Hadlock, WA
  • NPI 1245257054
  NPD (past)
• Earl Ross Fox, MD

  • Surgery Physician
  • Tacoma, WA
  • NPI 1306919725
  NPD (past)
• Myur S Srikanth, M. D.

  • Surgery Physician
  • Federal Way, WA
  • NPI 1558307363
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1811015399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 PACIFIC AVE",
            "address_2": "SUITE B",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984187836",
            "telephone_number": "253-472-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3716 PACIFIC AVE",
            "address_2": "SUITE B",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984187836",
            "telephone_number": "253-472-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL WEIGHT LOSS CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "ROSS",
        "authorized_official_title_or_position": "OWNER & SURGEON",
        "authorized_official_telephone_number": "253-472-9850",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "WA",
            "license": "MD0002094",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "WA",
            "license": "MD00005293",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR EARL ROSS FOX",
            "identifier": "1306919725",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR  SAMUEL ROSS FOX",
            "identifier": "1942363353",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS FOR EARL ROSS FOX",
            "identifier": "1016468",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS FOR SAMUEL ROSS FOX",
            "identifier": "8178618",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7124175",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edwin C. Supplee, PH.D.
• Heather Surerus-Lopez, RPH
• Neya Suresh Kumar
• Anand Suresh, MD
• Shawna M Surface, MHCA SUDPT
• Azure Surls
• Yvonne Surls, AARC
• Susan Poole, PHD, PLLC (Sage Spark Psychology)
• Jared Michael Sutherland, M.D.
• Sandra Sutherland

• Medical Specialty Clinic/Center in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Medical Specialty Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.