COMMUNITY SURGERY & LASER CENTER, LLC (NPI# 1205859550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205859550 |
| Entity Type | Organization |
| Organization Name | COMMUNITY SURGERY & LASER CENTER, LLC |
| Practice Address |
2 Farm Colony Drive Warren PA 16365-5206 |
| Practice Telephone | 8147262303 |
| Practice Fax Number | 8147267459 |
| Mailing Telephone | 8147262303 |
| Mailing Fax Number | 8147267459 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-10-21 |
| Authorized Official Name | GORDON EDGAR WUEBBOLT (OWNER/MD) |
| Authorized Official Telephone | 7164846700 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
MD052930L | PA | Ambulatory Health Care Facilities |
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
20821501 | PA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | NPI-DR. GORDON WUEBBOLT | 154-823-4255 | 01 |
| Street Address |
2 FARM COLONY DRIVE |
| City | WARREN |
| State | PA |
| Zip Code | 16365-5206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548234255 | Gordon Edgar Wuebbolt | Technician/Technologist | 2 Farm Colony Drive, Warren, PA 16365-5206 | 2006-02-17 |
| 1982811071 | Community Anesthesia Services, LLC | Nurse Anesthetist, Certified Registered | 2 Farm Colony Drive, Warren, PA 16365 | 2007-05-17 |
| 1528114311 | Community Eye Care Specialists, P.C. | Optometrist | 2 Farm Colony Drive, Warren, PA 16365-5206 | 2007-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932712759 | James Hickey | Dentist | 94 Egypt Hollow Rd, Warren, PA 16365 | 2020-08-31 |
| 1437674579 | Theresa Elizabeth Cook | Speech-Language Pathologist | Rehabworks At Warren General Hospital, Two Crescent Park West, Warren, PA 16365 | 2017-08-10 |
| 1891160982 | Vanessa Frank Humphrey | Occupational Therapy Assistant | 682 Pleasant Drive, Warren, PA 16365 | 2015-12-01 |
| 1740651967 | John L. Harrington | Psychiatry & Neurology | 4 Second Ave. Apt. #2, Warren, PA 16365 | 2015-10-14 |
| 1992046569 | Carrie Lynn Vaughn | Physical Therapy Assistant | 1048 Pennslvania Ave West, Warren, PA 16365 | 2013-03-07 |
| 1750664488 | William Frederick Menz | Pharmacist | 2901 Market Street, (walmart), Warren, PA 16365 | 2011-09-20 |
| 1669617296 | Donald Nicholas Vandamia | Family Medicine | 64 Leda Lane, Warren, PA 16365 | 2008-12-11 |
| 1013187558 | Chad Michael Ristau | Nurse Anesthetist, Certified Registered | 2 Crescent Park West., Warren General Hospital, Warren, PA 16365 | 2008-03-11 |
| 1407072473 | Family Physical Therapy | Physical Therapist | 218 Liberty St, Warren, PA 16365 | 2007-04-18 |
| 1801927330 | Wal-mart Stores East, L.p. | Technician/Technologist | 2901 Market St., Warren, PA 16365 | 2007-03-08 |
| Find all providers in zip 16365 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104179878 | Synergy Spine and Orthopedic Surgery Center, LLC | Clinic/Center | 5504 E 12 Mile Rd, Warren, MI 48092-4684 | 2012-10-18 |
| 1033730098 | Michigan Advanced Surgical Center, Pllc | Clinic/Center | 27101 Schoenherr Rd Ste 200, Warren, MI 48088-4730 | 2020-04-30 |
| 1013385046 | Interventional Pain Center Pllc | Clinic/Center | 27423 Van Dyke Ave, Warren, MI 48093-2867 | 2015-09-08 |
| 1528206562 | Southfield Rehabilition Company | Clinic/Center | 11012 E 13 Mile Rd, Suite 112a, Warren, MI 48093-2572 | 2009-01-29 |
| 1841333606 | Warren General Hospital | Clinic/Center | 2 W Crescent Park, Warren, PA 16365-2111 | 2007-02-14 |
| 1558451583 | Lippy Surgery Center LLC | Clinic/Center | 3893 E Market St, Warren, OH 44484-4706 | 2006-10-13 |
| 1558380675 | The Surgery Center, Howland | Clinic/Center | 1934 Niles Cortland Rd Ne, Warren, OH 44484-1055 | 2006-07-19 |
| 1396738936 | Warren Gastro Endoscopy Ctr Inc | Clinic/Center | 1622 E Market St, Warren, OH 44483-6613 | 2005-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871108068 | Tilden Ambulatory Surgery Center, LLC | Clinic/Center | 61 Industrial Dr, Hamburg, PA 19526-8768 | 2020-09-14 |
| 1447862834 | Us Cardio Washington LLC | Clinic/Center | 1000 Park Place Dr Ste 201, Washington, PA 15301-2064 | 2020-08-18 |
| 1518575778 | Eye Surgery of The Main Line, LLC | Clinic/Center | 333 E City Avenue, Two Bala Plaza, Bala Cynwyd, PA 19004-1501 | 2020-07-14 |
| 1053934919 | Doylestown Surgery Center, LLC | Clinic/Center | 593 West State Street, Doylestown, PA 18901 | 2020-05-26 |
| 1811534555 | Midlantic Urology Surgery Center, LLC | Clinic/Center | Valley Forge Office Center, Suite 100, 676-656 East Swedesford Road, Wayne, PA 19087 | 2019-12-02 |
| 1750927190 | Hermitage Endoscopy Center Inc | Clinic/Center | 949 N Hermitage Road, Hermitage, PA 16148 | 2019-11-20 |
| 1508400920 | Nazareth Endoscopy Center, LLC | Clinic/Center | 2401 Northampton St Ste 220, Easton, PA 18045-2764 | 2019-10-29 |
| 1235788878 | Integrated Surgical Institute, LLC | Clinic/Center | West Ridge Business Campus, 1001 James Drive, Leesport, PA 19533 | 2019-09-06 |
| 1841759040 | Beaver Valley Ambulatory Surgery Center, LLC | Clinic/Center | 79 Wagner Road, Suite 101, Monaca, PA 15061-2489 | 2019-03-18 |
| 1669931861 | Urology Health Surgery Center, LLC | Clinic/Center | 1974 Sproul Rd Ste 104, Broomall, PA 19008-3402 | 2019-03-18 |
| 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.