Organization Active NPI

Surgery Center of Bji, LLC

  • Ambulatory Surgical Clinic/Center
  • Jesup, GA
National Provider Identifier
1881911451
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
30633 Issued in GA
Legal business name
SURGERY CENTER OF BJI, LLC
Practice address
112 Professional Court
Jesup, GA 31545
Phone
(912) 427-0800
Fax
(912) 427-6029
NPI assigned
Apr 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Authorized official

Name
John Matthew Valosen, MDNPI 1447472048
Title
Owner/Surgeon
Phone
(912) 427-0800

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
Ambulatory Surgical Clinic/Center 261QA1903X 30633 GA Primary

Addresses

Primary practice location

112 Professional Court
Jesup, GA 31545

Mailing address

PO Box 1334
Jesup, GA 31598-1334
Phone (912) 427-0800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110729000262 GA Part B Supplier - Ambulatory Surgical Center 5597933929 Practice locations: Jesup, GA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Surgery Center of Bone and Joint InstituteCCN 11C0001361
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2006607Surgery Center of Bji, LLC112 Professional Court, Jesup, GA 31545Certificate of waiverApr 26, 2028

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1271894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1881911451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1334",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315981334",
            "telephone_number": "912-427-0800",
            "fax_number": "912-427-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 PROFESSIONAL COURT",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "31545",
            "telephone_number": "912-427-0800",
            "fax_number": "912-427-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER OF BJI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-22",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "VALOSEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER/SURGEON",
        "authorized_official_telephone_number": "912-427-0800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": "30633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jesup, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.