LAKE RIDGE AMBULATORY SURGERY CENTER, LLC (NPI# 1972850808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972850808 |
| Entity Type | Organization |
| Organization Name | LAKE RIDGE AMBULATORY SURGERY CENTER, LLC |
| Other Organization Name | LAKE RIDGE SURGERY CENTER |
| Practice Address |
12825 Minnieville Road Suite 204 Woodbridge VA 22192 |
| Practice Telephone | 7033579568 |
| Practice Fax Number | 7033579575 |
| Mailing Telephone | 7033579568 |
| Mailing Fax Number | 7033579575 |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2013-12-27 |
| Authorized Official Name | MRS. JANET M SMITH (ADMINISTRATOR) |
| Authorized Official Telephone | 7033579568 |
| 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 |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Lake Ridge Surgery Center | Doing Business As Name - Organization |
| Street Address |
12825 MINNIEVILLE ROAD SUITE 204 |
| City | WOODBRIDGE |
| State | VA |
| Zip Code | 22192 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992724413 | Elethia V Wampler | Physical Therapist | 12825 Minnieville Road, Suite 203, Woodbridge, VA 22192-0045 | 2006-07-18 |
| 1558619254 | Lake Ridge Anesthesia LLC | Anesthesiology | 12825 Minnieville Road, # 220, Woodbridge, VA 22192 | 2012-08-28 |
| 1194039511 | Greater Metropolitan Orthopaedic Institute | Internal Medicine | 12825 Minnieville Road, Suite 201/203, Woodbridge, VA 22192-0045 | 2010-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245873645 | Ursula Jackson | Technician | 3500 Commission Ct, Woodbridge, VA 22192 | 2019-10-18 |
| 1205480779 | Ki Soo Park | Physical Therapy Assistant | 12825 Minnieville Road Suite 201, Lake Ridge, VA 22192 | 2019-08-01 |
| 1801448329 | Karen Lee Trivett | Specialist/Technologist, Other | 12584 Darby Brook Court, Woodbridge, VA 22192 | 2019-07-15 |
| 1407313166 | Nichele Amelia Thompson | Behavioral Analyst | 2731 Marblestone Dr, 101, Woodbridge, VA 22192 | 2019-02-28 |
| 1952877870 | Kimberly Ann Rojas Vazquez | Behavioral Analyst | 12531 Clipper Dr, Suite 203, Woodbridge, VA 22192 | 2018-10-18 |
| 1104391614 | Ykim Dental | Dentist | 2680 Optiz Blvd., Suite 120, Woodbridge, VA 22192 | 2018-10-11 |
| 1013418755 | Arm Transport | Non-emergency Medical Transport (VAN) | 13000 Harbor Center Dr Ste 132d, Woodbridge, VA 22192 | 2018-02-27 |
| 1811496813 | Francesca Nasi | Behavioral Analyst | 12531 Clipper Dr Ste 203, Woodbridge, VA 22192 | 2018-02-05 |
| 1942729504 | Bismark Transportation Service LLC | Non-emergency Medical Transport (VAN) | 12341 Woodlawn Court, Woodbridge, VA 22192 | 2017-09-14 |
| 1992226344 | Arm Baby Eldery Home Health LLC | Home Health | 13000 Harbor Center Dr # 312c, Woodbridge, VA 22192 | 2017-07-06 |
| Find all providers in zip 22192 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649509027 | Advanced Urology P.c | Clinic/Center | 14904 Jefferson Davis Hwy, Suite 207, Woodbridge, VA 22191-3908 | 2009-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841815412 | Orthopaedic Surgery & Sports Med Specialist of Hampton Rds PC | Clinic/Center | 580 City Center Blvd, Newport News, VA 23606 | 2020-06-10 |
| 1093344210 | Virginia Womens Center for Aesthetics | Clinic/Center | 19490 Sandridge Way Ste 360, Leesburg, VA 20176-3467 | 2020-04-08 |
| 1306486634 | Fredericksburg Endoscopy Center, LLC | Clinic/Center | 1211 Central Park Blvd, Fredericksburg, VA 22401-4912 | 2020-01-15 |
| 1063058303 | Chesapeake Regional Surgery Center At Virginia Beach, LLC | Clinic/Center | 229 Clearfield Ave Ste 200, Virginia Beach, VA 23462-1815 | 2019-11-21 |
| 1154986347 | Center for Visual Surgical Excellence, LLC | Clinic/Center | 208 Carmichael Way, Chesapeake, VA 23322 | 2019-05-03 |
| 1720543481 | Surgical Suites of Coastal Virginia, LLC | Clinic/Center | 400 Sentara Cir Ste 200, Williamsburg, VA 23188-5716 | 2019-02-07 |
| 1962980045 | New Womens Health Charlottesville | Clinic/Center | 2050 Abbey Rd Ste D, Charlottesville, VA 22911-3553 | 2018-08-01 |
| 1518450790 | Virginia Ent Surgery Center Inc | Clinic/Center | 6600 W Broad St Ste 210, Richmond, VA 23230-1709 | 2018-06-12 |
| 1336649714 | Healthqare Services Asc LLC | Clinic/Center | 1005 N Glebe Rd Ste 200, Arlington, VA 22201-5792 | 2018-02-13 |
| 1104349489 | Valley Health Surgery Center, LLC | Clinic/Center | 174 Botanical Boulevard, Winchester, VA 22603 | 2017-07-19 |
| Find all providers with the same taxonomy | ||||
| City | WOODBRIDGE |
| Zip Code | 22192 |
Please comment or provide details below to improve the information on LAKE RIDGE AMBULATORY SURGERY CENTER, LLC.
| 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.