32ND Street Surgery Center, LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Joplin, MO
NPI 1962676304 · NPPES record last updated May 10, 2022
Key facts
- NPI
- 1962676304
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- License
- 247-0 (MO)
- Legal business name
- 32ND STREET SURGERY CENTER, LLC
- Practice address
- 1531 E 32ND Street
Suite 6
Joplin, MO 64804-2925 - Phone
- (417) 627-9699
- Fax
- (417) 627-9602
- NPI assigned
- Apr 16, 2008
- Organization subpart
- No
Authorized official
- Name
- Jeffrey E. Snodgrass
- Title
- President
- Phone
- (615) 665-1283
Member of 1
Member organizations 1
Medicare Care Compare: Ambulatory surgical center
- Listed as
- 32ND Street Surgery Center LLC
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D1081197 | 32ND Street Surgery Center | Certificate of waiver | Mar 11, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080501000016 | MO | Part B Supplier - Ambulatory Surgical Center | 7618056755 | Practice locations: Joplin, MO |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | 247-0 | MO | Yes |
Addresses
Primary practice location
1531 E 32ND Street
Suite 6
Joplin, MO 64804-2925
Mailing address
1A Burton Hills Blvd
Nashville, TN 37215-6187
Phone (615) 665-1283
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200588590A | Medicaid | KS |
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- A Bernard Short DDS PC
- A Meaningful Life, LLC
- ABA Hospice Care Mo 1 LLC
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- Dennis Michael Abbott
All providers in Joplin, MO · Ambulatory Surgical Clinic/Center in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.