SPRING PARK SURGERY CENTER L L C NPI 1073516795

NPI Information

NPI: 1073516795
Provider Name: SPRING PARK SURGERY CENTER L L C
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 16D1097399

Address:
3319 SPRING ST
STE 202A
DAVENPORT, IA
ZIP 52807
Phone: (563) 355-6236
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SPRING PARK SURGERY CENTER L L C is an ambulatory surgical clinic center in Davenport, IA. SPRING PARK SURGERY CENTER L L C NPI is 1073516795. The provider is registered as an organization entity type.

The provider's business location address is:

3319 SPRING ST
STE 202A
DAVENPORT, IA
ZIP 52807-125
Phone: (563) 355-6236
Fax: (563) 359-4634

The provider's authorized official is Katrina Mae Masakowski .
The authorized official title is Business Office Manager and has the following contact phone number (563) 359-1716.

The CLIA number assigned to this NPI record is 16D1097399 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/27/2005 and was last updated on 11/30/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical		IOWA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0610154	MEDICAID	IOWA
2	490004256	MEDICARE PIN	IOWA
3	61015	OTHER	IOWA	WELLMARK BCBS
4	490004256	OTHER	IOWA	MEDICARE RAILROAD
5	61015	MEDICARE PIN	IOWA
6	4895550001	MEDICARE NSC	IOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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