MARYVILLE SURGICAL CENTER (NPI# 1134120280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134120280 |
| Entity Type | Organization |
| Organization Name | MARYVILLE SURGICAL CENTER |
| Practice Address |
763 E Lamar Alexander Pkwy Maryville TN 37804-5000 |
| Practice Telephone | 8653809070 |
| Practice Fax Number | 8653809093 |
| Mailing Telephone | 8653809070 |
| Mailing Fax Number | 8653809093 |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. MARY ELLEN RIDER (ADMINISTRATOR) |
| Authorized Official Telephone | 8653809070 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
0000000107 | TN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3288166 | 05 |
| Street Address |
763 E LAMAR ALEXANDER PKWY |
| City | MARYVILLE |
| State | TN |
| Zip Code | 37804-5000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659835825 | Matthew David Mallory | Physical Therapist | Morning View Village 2320 E. Lamar Alexander Parway, Maryville, TN 37804 | 2019-01-22 |
| 1063937290 | Rachel Ryan Mcmillan | Counselor | 362 High Street, Maryville, TN 37804 | 2017-08-09 |
| 1316461460 | Steven Casey Boring | Nurse Practitioner | 907 E. Lamar Alexander Pkwy., Maryville, TN 37804 | 2017-07-31 |
| 1851738751 | Robert Kane Mccall | Pathology | 250 E. Broadway, Maryville, TN 37804 | 2013-05-31 |
| 1619242849 | Jennifer Mcclements | Physical Therapy Assistant | 4004 Samuel Circle, Maryville, TN 37804 | 2012-03-21 |
| 1316223886 | Sabrina Nicole Powers | Social Worker | 1704 East Broadway, Maryville, TN 37804 | 2011-10-28 |
| 1407138381 | Russmann, Inc. | Ambulance | 4163 Benny Delozier Drive, Maryville, TN 37804 | 2011-09-15 |
| 1184932485 | Complete Family Care of Maryville, Pllc | Internal Medicine | 2004 E. Broadway, Maryville, TN 37804 | 2010-09-21 |
| 1093975096 | Kristi Clark Correll | Speech-Language Pathologist | 2030 East Lamar Alexander Parkway, Maryville, TN 37804 | 2008-06-12 |
| 1134388267 | Barbara Frantz Poulsen | Speech-Language Pathologist | 2030 E Lamar Alexander Parkway, Maryville, TN 37804 | 2008-06-04 |
| Find all providers in zip 37804 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073593109 | Maryville Asc | Clinic/Center | 1706 E Lamar Alexander Pkwy, Maryville, TN 37804-6204 | 2006-01-17 |
| 1386641066 | Novamed Eye Surgery Center of Maryville, LLC | Clinic/Center | 12 Professional Park Dr, Maryville, IL 62062-5672 | 2005-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255939559 | Endoscopy Center of St Thomas Lp | Clinic/Center | 4230 Harding Pike Ste 309b, Nashville, TN 37205-2013 | 2020-10-09 |
| 1790344182 | Bristol Ambulatory Surgery Center, LLC | Clinic/Center | 350 Blountville Hwy Ste 108, Bristol, TN 37620-1676 | 2019-06-10 |
| 1528622321 | Premier-covenant Astc LLC | Clinic/Center | 6408 Papermill Dr Ste 220, Knoxville, TN 37919-4858 | 2019-04-26 |
| 1790348142 | The Plastic Surgery Center Brentwood | Clinic/Center | 620 Church Street East, Brentwood, TN 37027 | 2019-04-20 |
| 1326508045 | Eye Surgery Center of Lenoir City, LLC | Clinic/Center | 5491 Creekwood Park Blvd Ste B, Lenoir City, TN 37772-1204 | 2019-03-20 |
| 1629536826 | Meadowview Asc, LLC | Clinic/Center | 2033 Meadowview Ln Ste 210, Kingsport, TN 37660-7569 | 2019-03-06 |
| 1780157990 | Renaissance Surgery Center, LLC | Clinic/Center | 320 Bristol West Blvd Ste 1a, Bristol, TN 37620-8773 | 2019-01-10 |
| 1619487782 | Uch Vascular Access Asc LLC | Clinic/Center | 6490 Mt Moriah Rd Ext Ste 202, Memphis, TN 38115-3841 | 2017-10-03 |
| 1841712452 | Saint Thomas Surgery Center New Salem, LLC | Clinic/Center | 2755 New Salem Highway, Murfreesboro, TN 37128-3712 | 2017-07-14 |
| 1255860383 | Eye Surgery Center of Knoxville, LLC | Clinic/Center | 7739 Dannaher Drive, Powell, TN 37849 | 2017-06-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.