VISIONARY SURGERY CENTER LLC NPI 1821810326

NPI Information

  • NPI: 1821810326
  • Provider Name: VISIONARY SURGERY CENTER, LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • CLIA Number: 15D2323456
  • Address: VISIONARY SURGERY CENTER, LLC
    4335 EDISON LAKES PKWY
    MISHAWAKA, IN
    ZIP 46545
  • Phone: (417) 447-4484

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NPI Details

VISIONARY SURGERY CENTER, LLC is an ambulatory surgical clinic center in Mishawaka, IN. VISIONARY SURGERY CENTER, LLC NPI is 1821810326. The provider is registered as an organization entity type.

The provider's business location address is:

VISIONARY SURGERY CENTER, LLC
4335 EDISON LAKES PKWY
MISHAWAKA, IN
ZIP 46545
Phone: (417) 447-4484

The provider's authorized official is Erin Malloy .
The authorized official title is Administrator and has the following contact phone number (417) 447-4484.

The CLIA number assigned to this NPI record is 15D2323456 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/28/2024 and was last updated on 10/28/2024.

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
1261QA1903XClinic/CenterAmbulatory SurgicalYes

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: 11/21/2025

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