SOG SURGERY CENTER LLC (NPI# 1912480070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912480070 |
| Entity Type | Organization |
| Organization Name | SOG SURGERY CENTER LLC |
| Practice Address |
1211 S Gloster St Ste B Tupelo MS 38801-6535 |
| Mailing Address |
1211 S Gloster St Ste B Tupelo MS 38801-6548 |
| Practice Telephone | 6624321490 |
| Mailing Telephone | 6624321490 |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2020-06-04 |
| Authorized Official Name | THOMAS LUSTER (CEO) |
| Authorized Official Telephone | 6627674200 |
| 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 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1211 S Gloster St, Tupelo, MS 388016535 | 4178892040 |
| Street Address |
1211 S GLOSTER ST STE B |
| City | TUPELO |
| State | MS |
| Zip Code | 38801-6535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235738022 | Mississippi Anesthesia Consultants, LLC | Anesthesiology | 1211 S Gloster St Ste B, Tupelo, MS 38801-6548 | 2020-10-22 |
| 1871058792 | North Mississippi Anesthesia, LLC | Nurse Anesthetist, Certified Registered | 1211 S Gloster St Ste B, Tupelo, MS 38801-6535 | 2019-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1003443458 | Nicole Sherice Taylor | Nurse Practitioner | 845 South Gloster Street, Tupelo, MS 38801 | 2020-03-25 |
| 1821556838 | Wilco Healthcare of North Mississippi, Pllc | Point of Service | 1514 Co Rd 41, Tupelo, MS 38801 | 2019-03-08 |
| 1821565235 | Stephanie K Cagle | Nurse Practitioner | 218 S Thomas St Ste 120-121, Tupelo, MS 38801 | 2018-10-24 |
| 1073092326 | Lauren Parrish | Nurse Practitioner | 1573 Medical Park Circle, Tupelo, MS 38801 | 2018-08-08 |
| 1467948687 | North Mississippi Medcial Center, Inc. | Nurse Practitioner | 990 S Madison St Ste 2, Tupelo, MS 38801 | 2018-07-11 |
| 1043700933 | Hooks Diabetes & Medicine Clinic | Non-Pharmacy Dispensing Site | 2610 Traceland Drive, Ste A, Tupelo, MS 38801 | 2018-05-16 |
| 1073035903 | Annette C Riddle | Counselor | 1004 Eisenhower Drive, Tupelo, MS 38801 | 2017-07-12 |
| 1548709678 | Jaime Summers | Nurse Practitioner | 2780 West Jackson St, Tupelo, MS 38801 | 2017-02-22 |
| 1073975611 | Heath Bryan Coleman, Dds of Mississippi II, Pllc | Dentist | 1168 Cross Creek Drive, Tupelo, MS 38801 | 2016-03-23 |
| Find all providers in zip 38801 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154867562 | Urologic Ambulatory Surgery Center, LLC | Clinic/Center | 3353 N Gloster Street, Suite 300, Tupelo, MS 38804 | 2017-01-09 |
| 1548418320 | Comprehensive Pain Management LLC | Clinic/Center | 2089 South Ridge Dr., Tupelo, MS 38801-6478 | 2008-09-04 |
| 1134320831 | North Mississippi Pain Management Center | Clinic/Center | 4381 South Eason Blvd, Suite 203, Tupelo, MS 38801 | 2007-05-30 |
| 1235240813 | North Mississippi Ambulatory Surgery Center LLC | Clinic/Center | 589 Garfield St, Tupelo, MS 38801-6301 | 2006-08-31 |
| 1538110713 | Center for Digestive Health LLC | Clinic/Center | 589 Garfield St, Tupelo, MS 38801-6301 | 2006-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497391619 | Madison Spine Surgery Center, LLC | Clinic/Center | 160 Fountains Blvd Ste C, Madison, MS 39110-6380 | 2019-11-22 |
| 1588224802 | Flowood Surgery Center LLC | Clinic/Center | 120 Stone Creek Blvd Ste 400, Flowood, MS 39232-8210 | 2019-06-18 |
| 1942793823 | Starkville Surgery Center LLC | Clinic/Center | 110 Walker Way, Starkville, MS 39759-6607 | 2018-06-14 |
| 1194214510 | Specialty Surgery & Laser Center | Clinic/Center | 306 Bradley Rd Ste A, Corinth, MS 38834-7047 | 2018-05-02 |
| 1205218690 | Nurse Practitioner Professionals, Pllc | Clinic/Center | 427 Highway 51 Se, Kings Daughters Medical Center-wound Healing Center, Brookhaven, MS 39601 | 2015-06-23 |
| 1093121196 | Gulf Coast Outpatient Surgery Center, LLC | Clinic/Center | 2781 Ct Senior Switzer Drive, Suite 101, Biloxi, MS 39531 | 2014-07-09 |
| 1487094058 | Comprehensive Pain Center for Surgery | Clinic/Center | 129 Fountains Blvd., Madison, MS 39110 | 2013-06-27 |
| 1821336371 | Eyecare Surgery Center, LLC | Clinic/Center | 1501 Lakeland Dr Ste 101, Jackson, MS 39216-4839 | 2013-01-17 |
| 1518246081 | The Surgery Center LLC | Clinic/Center | 2466 Flowood Dr Ste A, Flowood, MS 39232 | 2011-08-15 |
| 1831413772 | Oxford Urocare Pllc | Clinic/Center | 1201 Medical Park Dr Ste 101, Oxford, MS 38655-5327 | 2010-03-22 |
| 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.