NPIMap

Organization Active NPI

Lake City Surgical Assistants LLC

  • Surgical Assistant
  • Somerset, KY
National Provider Identifier
1831896562
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
Legal business name
LAKE CITY SURGICAL ASSISTANTS LLC
Practice address
3602 Woodhaven Dr
Somerset, KY 42503-9512
Phone
(270) 250-1256
NPI assigned
Feb 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Authorized official

Name
Gregory Tyler Mann, CSFA KCSANPI 1144691650
Title
Ceo
Phone
(270) 250-1256

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 246ZC0007X Primary

Addresses

Primary practice location

3602 Woodhaven Dr
Somerset, KY 42503-9512

Mailing address

3602 Woodhaven Dr
Somerset, KY 42503-9512
Phone (270) 250-1256

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676246400000",
    "number": "1831896562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3602 WOODHAVEN DR",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425039512",
            "telephone_number": "270-250-1256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3602 WOODHAVEN DR",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425039512",
            "telephone_number": "270-250-1256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CITY SURGICAL ASSISTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "TYLER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "270-250-1256",
        "authorized_official_credential": "CSFA KCSA"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.