NPIMap

Organization Active NPI

Liberty Ambulatory Surgery Center LP

  • Ambulatory Surgical Clinic/Center
  • Liberty, MO
National Provider Identifier
1831206085
Registry record updated Dec 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
1611 Issued in MO
Legal business name
LIBERTY AMBULATORY SURGERY CENTER LP
Practice address
834 W Kansas St
Ste B
Liberty, MO 64068-2033
Phone
(816) 883-2004
Fax
(816) 883-2010
NPI assigned
Aug 24, 2006
Last updated
Dec 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2012

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

Authorized official

Name
Katherine L. Reed
Title
Officer, Authorized Official
Phone
(972) 763-3859

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 1611 MO Primary

Addresses

Primary practice location

834 W Kansas St
Ste B
Liberty, MO 64068-2033

Mailing address

834 W Kansas St
Ste B
Liberty, MO 64068-2033
Phone (816) 883-2004

Other identifiers 1

IdentifierTypeStateIssuer
506088509MedicaidMO

National Provider Directory

National Provider Directory

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

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": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355702400000",
    "number": "1831206085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 W KANSAS ST",
            "address_2": "STE B",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640682033",
            "telephone_number": "816-883-2004",
            "fax_number": "816-883-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 W KANSAS ST",
            "address_2": "STE B",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640682033",
            "telephone_number": "816-883-2004",
            "fax_number": "816-883-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY AMBULATORY SURGERY CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2012-12-17",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OFFICER, AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "972-763-3859"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MO",
            "license": "1611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "506088509",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; 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.