Grants Pass Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0504365 Issued in OR

Legal business name

GRANTS PASS SURGERY CENTER, LLC

Practice address

1601 NW Hawthorne Ave
Grants Pass, OR 97526-1041

Phone

(541) 472-4880

Fax

(541) 472-4899

NPI assigned

Jul 26, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Julie Ann Deger

Title

Office Manager

Phone

(541) 472-4884

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Listed as

Grants Pass Surgery CenterCCN 38C0001028

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1861492530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601NW HAWTHORNE AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261041",
            "telephone_number": "541-472-4880",
            "fax_number": "541-472-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 NW HAWTHORNE AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261041",
            "telephone_number": "541-472-4880",
            "fax_number": "541-472-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANTS PASS SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-26",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "DEGER",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "541-472-4884",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OR",
            "license": "0504365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165232",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grants Pass Nursing & Rehab Center LLC
• Grants Pass of Olympus, LLC
• Grants Pass Pharmacy, Inc.
• Grants Pass Pharmacy, Inc.
• Grants Pass Prosthodontics, PC
• Grants Pass Surgical Associates PC
• Grants Pass West of Olympus, LLC
• Green Tree Orthopedics, PC
• Cheron Marie Green, CDA
• Dagan Adair Green, MS PT

• Ambulatory Surgical Clinic/Center in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Ambulatory Surgical Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.