SURGCENTER OF FAYETTEVILLE, LLC
NPI 1477178879
Clinic/Center - Ambulatory Surgical in Fayetteville, AR

Q: What is Surgcenter Of Fayetteville, LLC's NPI number?

The NPI number for Surgcenter Of Fayetteville, LLC is 1477178879. It was assigned to this organization in the NPPES registry on June 11, 2020.

Q: What is Surgcenter Of Fayetteville, LLC's specialty?

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

Active since June 11, 2020CLIA 04D2187757 · Waiver

1905 E MISSION BLVD STE 5, FAYETTEVILLE, AR 72703(501) 554-1273 Get Directions Write a Review

NPPES record last updated: June 11, 2020. Verified against the NPPES registry weekly; last sync: September 06, 2026.

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About Surgcenter Of Fayetteville, Llc NPPES

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

SURGCENTER OF FAYETTEVILLE, LLC (NPI 1477178879) is a healthcare organization registered as an ambulatory surgical in Fayetteville, Arkansas and active in the NPI registry since June 2020. The organization holds a CLIA Waiver certificate valid through July 6, 2028 and lists Kelli Young, Adminsitrator, as its authorized official.

NPPES Registry Identity

NPI1477178879

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameSURGCENTER OF FAYETTEVILLE, LLC

Location Address1905 E MISSION BLVD STE 5Fayetteville, AR 72703-3129

Mailing Address1905 E Mission Blvd Ste 5Fayetteville, AR 72703-3129 · (501) 554-1273

Phone(501) 554-1273

Organization SubpartNo

Authorized OfficialKelli YoungAdminsitrator · (501) 554-1273

Enumeration DateJune 11, 2020

NPPES CertifiedJune 11, 2020

✔ NPI 1477178879 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities

Taxonomy Code261QA1903X

1905 E MISSION BLVD STE 5, Fayetteville, AR 72703

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

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 04D2187757

Surgcenter Of Fayetteville, LLC · Fayetteville, AR

Active · expires Jul 6, 2028

CLIA Number04D2187757

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateJuly 7, 2026

Certificate Expiration DateJuly 6, 2028

Laboratory DirectorDr. Mark Miedema

Laboratory Phone(479) 439-4959

Laboratory LocationSurgcenter Of Fayetteville, LLC1905 E Mission Blvd, Suite 5, Fayetteville, AR 72703

CLIA data matches this NPI record on: Address Name

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

Areas of Expertise CMS Part B claims 21

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, bupivacaine liposome, 1 mg C9290

Bupivacaine liposome is a local anesthetic used to numb a specific area of the body and reduce pain or discomfort associated with surgical procedures. The 1 mg dosage is injected by a healthcare professional at the required site.

11,512 services82 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level 64483

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

1,019 services449 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level 64493

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

302 services105 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint 64635

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

206 services112 patients

Insertion of spinal neurostimulator electrode array through skin 63650

This procedure involves placing a small device, called a neurostimulator electrode array, under your skin near your spine. It delivers mild electrical signals to your spinal cord, helping to manage chronic pain.

167 services52 patients

Injection of substance into middle or upper spine canal using imaging guidance 62321

This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.

133 services96 patients

Insertion or replacement of spinal neurostimulator generator or receiver 63685

The insertion of a spinal neurostimulator generator or receiver is a procedure to manage chronic pain. A small device is implanted under your skin, which sends mild electrical signals to your spinal cord. These signals disrupt pain signals, helping to reduce discomfort.

63 services63 patients

Imaging guidance for procedure, 60 minutes or less 76000

Imaging guidance is a procedure where real-time images are used to direct medical tools during a treatment. This technique helps to improve accuracy and safety. The procedure typically lasts 60 minutes or less.

54 services52 patients

Release and/or relocation of hand nerve 64721

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.

48 services41 patients

Injection of upper or middle spine facet joint using imaging guidance, single level 64490

This procedure involves injecting medication into a joint in your upper or middle spine. It's performed under imaging guidance for precision. The aim is to reduce inflammation and pain. It's a single-level process, meaning one joint is treated at a time.

44 services17 patients

Incision of tendon covering of finger 26055

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.

38 services27 patients

Correction of toe joint deformity 28285

Correction of toe joint deformity is a procedure to fix misshapen toe joints. This can involve realigning the bones, removing bone or tissue, or implanting devices to improve joint function. It can help reduce pain and improve mobility.

30 services16 patients

Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography G0260

This procedure involves injecting medicine into the sacroiliac joint, located in the lower back. The aim is to reduce inflammation and pain. Anesthetic is used for immediate pain relief, while a steroid helps decrease inflammation over time. Arthrography, a type of imaging, may be used for precision.

30 services19 patients

Injection of substance into lower spine canal using imaging guidance 62323

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

28 services19 patients

Fusion of big toe at joint with foot 28750

Fusion of the big toe at the joint with the foot, also known as arthrodesis, is a surgical procedure aimed at relieving pain and improving stability. It involves permanently connecting the bones of the big toe and foot, which can limit movement but often enhances comfort and function.

27 services25 patients

Repair of shoulder rotator cuff using an endoscope 29827

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.

23 services23 patients

Injection of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance, single level 64479

This procedure involves injecting anesthetic or steroid medication into a specific nerve root in the upper or middle spine. It's performed using imaging technology for precise placement. The aim is to reduce inflammation and alleviate pain.

23 services13 patients

Partial removal of collar bone at shoulder using an endoscope 29824

This procedure involves the partial removal of the collar bone at the shoulder using an endoscope, a tool with a light and camera. It's done to relieve pain or improve shoulder movement. The surgeon makes small incisions, then uses the endoscope to guide their work.

16 services16 patients

Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint 64633

This procedure involves the use of imaging technology to guide a needle to the nerves of a single facet joint in the upper or middle spine. The nerves are then treated to alleviate pain and improve mobility.

16 services12 patients

Removal of bone from lower spine for decompression of nerve tissue using imaging guidance, accessed through the skin 0275T

This procedure involves removing a small portion of bone from your lower spine. The goal is to relieve pressure on your nerve tissue, improving comfort and mobility. It is done through the skin using imaging technology to ensure precision and safety.

12 services12 patients

Removal or revision of spinal neurostimulator generator or receiver 63688

The procedure involves the removal or revision of a neurostimulator generator or receiver, a device implanted under the skin to send electrical pulses to the brain or spinal cord. This helps manage chronic pain or neurological disorders. The procedure might be needed if the device malfunctions, or to replace its battery.

12 services12 patients

Other Providers at the Same Location NPPES

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

FAYETTEVILLE ANESTHESIA ASSOCIATES LLC

Anesthesiology

1905 E MISSION BLVD STE 5
FAYETTEVILLE, AR 72703

Washington County (479) 439-4959

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Surgcenter Of Fayetteville, LLC's NPI number?

The NPI number for Surgcenter Of Fayetteville, LLC is 1477178879. It was assigned to this organization in the NPPES registry on June 11, 2020.

Where is Surgcenter Of Fayetteville, LLC located?

Surgcenter Of Fayetteville, LLC is located at 1905 E Mission Blvd Ste 5, Fayetteville, AR 72703. The listed phone number is (501) 554-1273.

What is Surgcenter Of Fayetteville, LLC's specialty?

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

Does Surgcenter Of Fayetteville, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D2187757) is associated with this NPI, valid through July 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Surgcenter Of Fayetteville, LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 5 other insurers list Surgcenter Of Fayetteville, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Surgcenter Of Fayetteville, LLC was last updated on June 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.