SOUTHERN KENTUCKY SURGICENTER, LLC
NPI 1063999662
Clinic/Center - Ambulatory Surgical in Bowling Green, KY

NPI Status: Active since July 26, 2018

Contact Information

484 GOLDEN AUTUMN WAY
SUITE 100
BOWLING GREEN, KY
ZIP 42103
Phone: (270) 938-6500

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • CLIA Number: 18D2156338
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 10-15-2026

About SOUTHERN KENTUCKY SURGICENTER, LLC

This page provides the complete NPI Profile along with additional information for Southern Kentucky Surgicenter, Llc, a provider established in Bowling Green, Kentucky operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1063999662 assigned on July 2018. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated June 2026. The provider's . The authorized official of this NPI record is David Mcknight (Vp/cfo)

NPI
1063999662
Provider Legal Name
SOUTHERN KENTUCKY SURGICENTER, LLC
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
484 GOLDEN AUTUMN WAY SUITE 100 BOWLING GREEN, KY 42103
Location Phone
(270) 938-6500
Mailing Address
484 GOLDEN AUTUMN WAY STE 100 BOWLING GREEN, KY 42103
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-26-2018
Last Update Date
06-04-2026
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DAVID MCKNIGHT

Authorized Official Title
VP/CFO
Authorized Official Phone
(972) 789-2816

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm

This procedure involves using a flexible tube with a camera, called an endoscope, to gently expand narrowed areas in your esophagus, stomach, or upper small bowel. A small balloon is inflated, making it easier for food and liquid to pass through. It's safe and effective.

This service was performed 24 times for 21 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

This service was performed 138 times for 133 patients

Biopsy of large bowel using a flexible endoscope

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

This service was performed 216 times for 214 patients

Colorectal cancer screening; colonoscopy on individual at high risk

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

This service was performed 41 times for 41 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

This service was performed 63 times for 63 patients

Complex removal of cataract with insertion of prosthetic lens

This procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.

This service was performed 47 times for 31 patients

Diagnostic exam of large bowel using a flexible endoscope

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

This service was performed 11 times for 11 patients

Incision of tendon covering of finger

This procedure involves making a small cut into the protective sheath around a finger tendon. It's typically done to relieve pressure or inflammation, improve finger movement, or treat conditions like trigger finger. It's a safe, often outpatient procedure.

This service was performed 25 times for 18 patients

Injection, non-radioactive, non-contrast, visualization adjunct (e.g., methylene blue, isosulfan blue), 1 mg

This procedure involves an injection of a non-radioactive, non-contrast substance like methylene blue or isosulfan blue. It's used to enhance visualization during certain medical procedures, improving accuracy and safety.

This service was performed 13 times for 12 patients

Prosthetic repair of shoulder joint, total shoulder

Total shoulder prosthetic repair is a surgical procedure to replace a damaged shoulder joint with artificial components. It aims to relieve pain and restore mobility. The procedure involves replacing the ball (humeral head) and socket (glenoid) of the shoulder joint.

This service was performed 15 times for 15 patients

Release and/or relocation of elbow nerve

This procedure involves adjusting the position of a nerve in your elbow to alleviate discomfort or improve function. The nerve is carefully moved from its original location and placed in a less strained position. This can help reduce pain and improve arm movement.

This service was performed 20 times for 17 patients

Release and/or relocation of hand nerve

This procedure involves adjusting or moving a nerve in your hand to alleviate discomfort or improve function. The nerve may be compressed, causing pain or numbness. By releasing or relocating the nerve, these symptoms can be reduced, enhancing hand usage.

This service was performed 55 times for 51 patients

Removal of both knee cartilages using an endoscope

This procedure, also known as bilateral knee arthroscopy, involves using a small camera (endoscope) to view and remove damaged cartilage from both knees. It's a minimally invasive surgery aimed at relieving pain and improving mobility.

This service was performed 15 times for 15 patients

Removal of cataract with insertion of prosthetic lens

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

This service was performed 607 times for 330 patients

Removal of connective tissue of palm and release of finger, first digit

This procedure involves removing certain tissue in your palm to alleviate tension, and releasing the first digit (thumb) if it's constricted. It's done to improve hand function and reduce discomfort. It's a common treatment for conditions like Dupuytren's contracture.

This service was performed 13 times for 13 patients

Removal of knee cartilage using an endoscope

This procedure, known as arthroscopic knee surgery, involves using a small camera (endoscope) to view the inside of your knee. Small instruments are used to remove damaged cartilage. This can help alleviate pain and improve knee function.

This service was performed 20 times for 20 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

This service was performed 238 times for 236 patients

Repair of shoulder rotator cuff using an endoscope

This procedure, known as arthroscopic rotator cuff repair, helps fix tears in the shoulder's rotator cuff. An endoscope, a small camera, is used to view the shoulder inside. Using small tools, the surgeon repairs the torn tissue. This minimally invasive approach often leads to a quicker recovery.

This service was performed 16 times for 15 patients

Replacement of knee joint, both sides of knee

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

This service was performed 71 times for 65 patients

Replacement of thigh bone and hip joint with prosthesis

This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.

This service was performed 19 times for 18 patients

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 this NPI number is:

CLIA Number
18D2156338
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
October 16, 2024
Certificate Expiration Date
October 15, 2026
Laboratory Director
DR. DAVID M. SMITH
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Southern Kentucky Surgicenter, Llc 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.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1063999662, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
3
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
9
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
6
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 9 → 18 → 9 9 → 18 → 9 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 2 + 3 + 1 + 8 + 9 + 1 + 8 + 6 + 1 + 2 + 24 = 68

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 68 is 70. The difference is the calculated check digit.

70 - 68 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1063999662.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Optometrist
484 GOLDEN AUTUMN WAY
BOWLING GREEN, KY 42103

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1063999662, enumerated as an "organization" on July 26, 2018.

The provider is located at 484 GOLDEN AUTUMN WAY SUITE 100 BOWLING GREEN, KY 42103 and the phone number is (270) 938-6500.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.