SURGICAL CENTER OF GREENSBORO LLC
NPI 1033660451
Clinic/Center - Ambulatory Surgical in Greensboro, NC

Q: What is Surgical Center Of Greensboro LLC's NPI number?

The NPI number for Surgical Center Of Greensboro LLC is 1033660451. It was assigned to this organization in the NPPES registry on October 20, 2016.

Q: What is Surgical Center Of Greensboro LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Active since October 20, 2016CLIA 34D0238936 · Waiver

705 GREEN VALLEY RD, GREENSBORO, NC 27408(336) 272-0012(336) 544-2150 Get Directions Write a Review

NPPES record last updated: January 24, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 24, 2019, Oct 20, 2016 (2 updates tracked since 2016).

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About Surgical Center Of Greensboro Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SURGICAL CENTER OF GREENSBORO LLC (NPI 1033660451) is a healthcare organization registered as an ambulatory surgical in Greensboro, North Carolina and active in the NPI registry since October 2016. The organization holds a CLIA Waiver certificate valid through November 12, 2026, maintains a secondary practice location in Greensboro, and lists Jennifer Graham, Chief Administrative Officer, as its authorized official.

NPPES Registry Identity

NPI1033660451

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameSURGICAL CENTER OF GREENSBORO LLC

Location Address705 GREEN VALLEY RDGreensboro, NC 27408-7019

Mailing Address705 Green Valley RdGreensboro, NC 27408-7019 · (336) 272-0012 · Fax (336) 544-2150

Phone(336) 272-0012

Fax(336) 544-2150

Organization SubpartNo

Authorized OfficialJennifer GrahamChief Administrative Officer · (336) 272-0012

Enumeration DateOctober 20, 2016

Last NPPES UpdateJanuary 24, 20192 updates tracked since enumeration

✔ NPI 1033660451 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities

Taxonomy Code261QA1903X

License✔ Licensed in NC · AS0018

705 GREEN VALLEY RD, Greensboro, NC 27408

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Secondary Practice Location 1

Location 11211 Virginia StreetGreensboro, NC 27401 · Phone (336) 272-0012 ext. 5281 · Fax (336) 544-2150

Other Identifiers 1

Medicaid3409923NC

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D0238936

Surgical Center Of Greensboro, LLC · Greensboro, NC

Active · expires Nov 12, 2026

CLIA Number34D0238936

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateNovember 13, 2024

Certificate Expiration DateNovember 12, 2026

Laboratory DirectorBrian Paitsel

Laboratory Phone(336) 272-0012

Laboratory LocationSurgical Center Of Greensboro, LLC705 Green Valley Road, Greensboro, NC 27408

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SURGICAL CENTER OF GREENSBORO, LLC

Clinic/Center (Ambulatory Surgical)