Baptist South Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BAPTIST SOUTH SURGERY CENTER, LLC

Doing business as

Horizon Surgery Center South

Practice address

14540 Old St. Augustine Road
Medical Office BLDG. 2
Jacksonville, FL 32258-7418

Phone

(904) 648-0100

Fax

(904) 618-2159

NPI assigned

Jan 25, 2023

Organization subpart

No

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

Authorized official

Name

Catherine Graham

Title

SVP, Clin SVC LN & Amb Bus Dev

Phone

(904) 202-2230

Specialties & licenses 1

Addresses

Other names 1

• Horizon Surgery Center South Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Ambulatory surgical center certification: CCN 10C0001761

Legal name

BAPTIST SOUTH SURGERY CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Mar 27, 2025

Last certification

Mar 5, 2025

Facility address

14540 Old St Augustine Rd, Mob 2
Jacksonville, FL 32258

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1952017832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14540 OLD ST. AUGUSTINE ROAD",
            "address_2": "MEDICAL OFFICE BLDG. 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322587418",
            "telephone_number": "904-648-0100",
            "fax_number": "904-618-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14540 OLD ST. AUGUSTINE ROAD",
            "address_2": "MEDICAL OFFICE BLDG. 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322587418",
            "telephone_number": "904-648-0100",
            "fax_number": "904-618-2159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST SOUTH SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-25",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "SVP, CLIN SVC LN & AMB BUS DEV",
        "authorized_official_telephone_number": "904-202-2230"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Horizon Surgery Center South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.