LINCOLN MEDICAL CENTER SURGICAL CLINIC NPI 1023299823

Clinic/Center in Fayetteville, TN

NPI 1023299823 Organization Clinic/Center CLIA Number 44D1065410 CLIA Certificate of Waiver

About LINCOLN MEDICAL CENTER SURGICAL CLINIC

Lincoln Medical Center Surgical Clinic is a provider established in Fayetteville, Tennessee specializing in clinic/center. The NPI number of Lincoln Medical Center Surgical Clinic is 1023299823 and was assigned on November 2007. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Mr. David Groce Cfo (Cfo)

The CLIA number of Lincoln Medical Center Surgical Clinic is 44D1065410 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Lincoln Medical Center Surgical Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1023299823

Provider NameLINCOLN MEDICAL CENTER SURGICAL CLINIC
Provider Location Address108 MEDICAL CENTER BLVD SUITE 175 FAYETTEVILLE, TN 37334
Provider Mailing Address108 MEDICAL CENTER BLVD SUITE 175 FAYETTEVILLE, TN 37334
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?Yes
Enumeration Date11-20-2007
Last Update Date04-20-2008


Primary Taxonomy

Taxonomy Code261Q00000X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
Taxonomy DescriptionA facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Business Address

LINCOLN MEDICAL CENTER SURGICAL CLINIC
108 MEDICAL CENTER BLVD
SUITE 175
FAYETTEVILLE, TN
ZIP 37334
Phone: (931) 438-1100
Fax: (931) 438-7491

Get Directions


Mailing Address

LINCOLN MEDICAL CENTER SURGICAL CLINIC
108 MEDICAL CENTER BLVD
SUITE 175
FAYETTEVILLE, TN
ZIP 37334
Phone: (931) 438-1100
Fax: (931) 438-7491



Authorized Official

Authorized Official NameMR. DAVID GROCE CFO
Authorized Official TitleCFO
Authorized Official Phone(931) 438-7471

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1023299823 is:

CLIA Number44D1065410
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
=========OTHER (01)TN

Other Providers at the same location


The following 17 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1285748962PARKWAY MEDICAL GROUP, PC
Organization
Family Medicine108 MEDICAL CENTER BLVD SUITE G-50
FAYETTEVILLE, TN 37334
(931) 438-4111
1710097290 LE ROY GURGANIOUS M.D.
Individual
Orthopaedic Surgery108 MEDICAL CENTER BLVD SUITE 100
FAYETTEVILLE, TN 37334
(931) 433-1102
1619065570 PHILIP M MONKS RT
Individual
Radiologic Technologist (Radiography)108 MEDICAL CENTER BLVD
FAYETTEVILLE, TN 37334
(931) 438-9085
1114015153MONKS IMAGING LLC
Organization
Radiologic Technologist108 MEDICAL CENTER BLVD BOX 7
FAYETTEVILLE, TN 37334
(931) 438-9085
1174824783TOP FLIGHT MEDICAL GROUP LLC
Organization
Specialist108 MEDICAL CENTER BLVD SUITE G25
FAYETTEVILLE, TN 37334
(615) 340-3436
1760783104LINCOLN MEDICAL CENTER ORTHOPEDIC CLINIC
Organization
Orthopaedic Surgery108 MEDICAL CENTER BLVD SUITE 100
FAYETTEVILLE, TN 37334
(931) 433-1102
1760780688LINCOLN EAR NOSE AND THROAT
Organization
Otolaryngology108 MEDICAL CENTER BLVD SUITE 175
FAYETTEVILLE, TN 37334
(931) 433-2909
1053604298LINCOLN MEDICAL CENTER OBGYN CLINIC
Organization
Obstetrics & Gynecology108 MEDICAL CENTER BLVD SUITE 150
FAYETTEVILLE, TN 37334
(931) 433-1105
1497862999 WILLIAM D HUGHES M.D.
Individual
Family Medicine108 MEDICAL CENTER BLVD SUITE G-50
FAYETTEVILLE, TN 37334
(931) 438-4111
1043357916 RICHARD WILLIAM CLINE JR. D.O.
Individual
Family Medicine108 MEDICAL CENTER BLVD SUITE G-50
FAYETTEVILLE, TN 37334
(931) 438-4111
1356895999MRS. KATRINA MARGARET DIAL CNM
Individual
Advanced Practice Midwife108 MEDICAL CENTER BLVD SUITE 150
FAYETTEVILLE, TN 37334
(931) 433-1105
1578885620LINCOLN MEDICAL GROUP
Organization
Specialist108 MEDICAL CENTER BLVD SUITE 150
FAYETTEVILLE, TN 37334
(931) 433-1105
1134248990TENNESSEE ONCOLOGY PLLC
Organization
Internal Medicine (Hematology & Oncology)108 MEDICAL CENTER BLVD STE G25
FAYETTEVILLE, TN 37334
(931) 433-3477
1497957237LINCOLN MEDICAL CENTER ORTHOPEDIC CLINIC
Organization
Orthopaedic Surgery108 MEDICAL CENTER BLVD STE 175
FAYETTEVILLE, TN 37334
(931) 438-1100
1811165616LINCOLN MEDICAL CENTER CARDIOLOGY CLINIC
Organization
Specialist108 MEDICAL CENTER BLVD SUITE 125
FAYETTEVILLE, TN 37334
(931) 438-7482
1326052408 WILLIAM A EDWARDS M.D.
Individual
Family Medicine108 MEDICAL CENTER BLVD SUITE G 50
FAYETTEVILLE, TN 37334
(931) 438-4111
1497869259 JAMES A GRAY M.D.
Individual
Family Medicine108 MEDICAL CENTER BLVD SUITE G-50
FAYETTEVILLE, TN 37334
(931) 438-4111

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.