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EAST TENNESSEE AMBULATORY SURGERY CENTER LLC
NPI 1659360071
Clinic/Center - Ambulatory Surgical in Johnson City, TN

Active since October 18, 2005CLIA 44D0964457 · Waiver
701 MED TECH PKWY, JOHNSON CITY, TN 37604(423) 283-7302(423) 282-3670 Get Directions Write a Review

NPPES record last updated: April 20, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About East Tennessee Ambulatory Surgery Center Llc NPPES

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

EAST TENNESSEE AMBULATORY SURGERY CENTER LLC (NPI 1659360071) is a healthcare organization registered as an ambulatory surgical in Johnson City, Tennessee and active in the NPI registry since October 2005. The organization holds a CLIA Waiver certificate valid through August 25, 2027 and lists Jim N Brantner, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1659360071
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameEAST TENNESSEE AMBULATORY SURGERY CENTER LLC
Location Address701 MED TECH PKWYJohnson City, TN 37604-2259
Mailing Address701 Med Tech PkwyJohnson City, TN 37604-2259 · (423) 283-7302 · Fax (423) 282-3670
Phone(423) 283-7302
Fax(423) 282-3670
Organization SubpartNo
Authorized OfficialJim N BrantnerMedical Director · (423) 283-7302
Enumeration DateOctober 18, 2005
Last NPPES UpdateApril 20, 2008
✔ NPI 1659360071 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 TN · 0000000109
701 MED TECH PKWY, Johnson City, TN 37604
Open in Google Maps ↗

Other Identifiers 6

Medicare ID-Type Unspecified3288092TN
Other145422Umwa
Medicaid3288092TN
Other3135707Bcbs Of Tn
Other0007447071Aetna
Other3135707TN · Bcbs Tenncare

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 Magnolia Health 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 44D0964457

East Tennessee Ambulatory Surgery Center · Johnson City, TN
Active · expires Aug 25, 2027
CLIA Number44D0964457
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateAugust 26, 2025
Certificate Expiration DateAugust 25, 2027
Laboratory DirectorJim N. Brantner
Laboratory Phone(423) 610-3602
Laboratory LocationEast Tennessee Ambulatory Surgery Center701 Med-Tech Parkway Suite 100, Johnson City, TN 37604
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 8

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 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.
66 services23 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.
46 services23 patients
Biopsy of large bowel using a flexible endoscope 45380
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.
40 services40 patients
Partial removal of breast 19301
A partial removal of the breast, also known as a lumpectomy, involves taking out a portion of the breast tissue to eliminate concerning cells. It's typically performed when the problem area is limited in size. This procedure helps to preserve most of the breast's appearance while aiming to remove all the unhealthy cells.
33 services29 patients
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121
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.
31 services31 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.
27 services12 patients

Other Providers at the Same Location NPPES 19

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

ALLIANCE ANESTHESIA PLLC
Nurse Anesthetist, Certified Registered
701 MED TECH PKWY, SUITE 300
JOHNSON CITY, TN 37604
Washington County (615) 620-2320
AMBER PRESTON BUTLER FNP
Nurse Practitioner (Family)
701 MED TECH PKWY, SUITE 300
JOHNSON CITY, TN 37604
Washington County (423) 232-8301
MR. WESLEY EUGENE PERRY PA
Physician Assistant (Surgical)
701 MED TECH PKWY, SUITE 300
JOHNSON CITY, TN 37604
Washington County (423) 232-8301
CATHERINE MOYER DPT
Physical Therapist
701 MED TECH PKWY, SUITE 301
JOHNSON CITY, TN 37604
Washington County (423) 232-8302
BAILEY ELIZABETH QUALLS PA-C
Physician Assistant
701 MED TECH PKWY, SUITE 300
JOHNSON CITY, TN 37604
Washington County (423) 232-8301
HOLLY WHITT
Physical Therapist
701 MED TECH PKWY, SUITE 301
JOHNSON CITY, TN 37604
Washington County (615) 373-1350
SHANE STEPHENS
Nurse Practitioner (Psychiatric/Mental Health)
701 MED TECH PKWY
JOHNSON CITY, TN 37604
Washington County (423) 302-3480
EAST TENNESSEE ANESTHESIA SERVICES, PLLC
Anesthesiology
701 MED TECH PKWY
JOHNSON CITY, TN 37604
Washington County (423) 283-7302

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 East Tennessee Ambulatory Surgery Center LLC's NPI number?

The NPI number for East Tennessee Ambulatory Surgery Center LLC is 1659360071. It was assigned to this organization in the NPPES registry on October 18, 2005.

Where is East Tennessee Ambulatory Surgery Center LLC located?

East Tennessee Ambulatory Surgery Center LLC is located at 701 Med Tech Pkwy, Johnson City, TN 37604. The listed phone number is (423) 283-7302.

What is East Tennessee Ambulatory Surgery Center LLC's specialty?

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

Does East Tennessee Ambulatory Surgery Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D0964457) is associated with this NPI, valid through August 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does East Tennessee Ambulatory Surgery Center LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of North Carolina and 2 other insurers list East Tennessee Ambulatory Surgery Center 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 East Tennessee Ambulatory Surgery Center LLC was last updated on April 20, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.