Spectrum Surgical Assisting LLC

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

Legal business name

SPECTRUM SURGICAL ASSISTING LLC

Practice address

146 Martin Luther King Jr Blvd #302
Monroe, GA 30655

Phone

(386) 479-9575

NPI assigned

Jul 24, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Frank Paul Tanner, LCSA

Title

Owner/Licensed Csa

Phone

(386) 960-4534

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457049600000",
    "number": "1912315763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 MARTIN LUTHER KING JR BLVD #302",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "30655",
            "telephone_number": "386-479-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 MARTIN LUTHER KING JR BLVD #302",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "30655",
            "telephone_number": "386-479-9575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM SURGICAL ASSISTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-24",
        "last_updated": "2016-03-04",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER/LICENSED CSA",
        "authorized_official_telephone_number": "386-960-4534",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSA"
    },
    "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": []
}

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• Surgical Assistant in Monroe, GA
• Providers in Monroe, GA by specialty
• Surgical Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; 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.