SULLIVAN SURGICENTER,LLC
NPI 1700854072
Clinic/Center - Ambulatory Surgical in Sullivan, IN

Q: What is Sullivan Surgicenter,llc's NPI number?

The NPI number for Sullivan Surgicenter,llc is 1700854072. It was assigned to this organization in the NPPES registry on March 10, 2006.

Q: What is Sullivan Surgicenter,llc's specialty?

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

Active since March 10, 2006CLIA 15D1030552 · Waiver

320 N SECTION ST, SULLIVAN, IN 47882(812) 268-9000(812) 268-8822 Get Directions Write a Review

NPPES record last updated: December 6, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Sullivan Surgicenter,llc NPPES

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

SULLIVAN SURGICENTER,LLC (NPI 1700854072) is a healthcare organization registered as an ambulatory surgical in Sullivan, Indiana and active in the NPI registry since March 2006. The organization holds a CLIA Waiver certificate valid through September 8, 2026 and lists Custodio L Lim, Ceo, as its authorized official.

NPPES Registry Identity

NPI1700854072

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameSULLIVAN SURGICENTER,LLC

Location Address320 N SECTION STSullivan, IN 47882-1239

Mailing Address320 N Section StSullivan, IN 47882-1239 · (812) 268-9000 · Fax (812) 268-8822

Phone(812) 268-9000

Fax(812) 268-8822

Organization SubpartNo

Authorized OfficialCustodio L LimCeo · (812) 268-9000

Enumeration DateMarch 10, 2006

Last NPPES UpdateDecember 6, 2012

✔ NPI 1700854072 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 IN · 05-003633-1

320 N SECTION ST, Sullivan, IN 47882

Open in Google Maps ↗

Other Identifiers 2

Medicare ID-Type UnspecifiedZR5090IN

Medicaid200503030IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.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 15D1030552

Sullivan Surgicenter LLC · Sullivan, IN

Active · expires Sep 8, 2026

CLIA Number15D1030552

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateSeptember 9, 2024

Certificate Expiration DateSeptember 8, 2026

Laboratory DirectorKelly J. Gilham

Laboratory Phone(812) 268-9000

Laboratory LocationSullivan Surgicenter LLC320 N Section St, Sullivan, IN 47882

CLIA data matches this NPI record on: Address Name Phone

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

Areas of Expertise CMS Part B claims 12

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.

Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm 11402

This procedure involves the removal of a noncancerous skin growth on the body, arms, or legs that is between 1.1 and 2.0 cm in size. It's a safe and routine procedure performed by a medical professional to improve your skin health and appearance.

103 services73 patients

Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm 11642

This procedure involves the surgical removal of a cancerous skin growth on the face, ears, eyelids, nose, lips, or mouth. The growth is between 1.1-2.0 cm in size. This is done to prevent the cancer from spreading and to restore health.

100 services73 patients

Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm 11422

This procedure involves the removal of a noncancerous skin growth in areas such as the scalp, neck, hands, or feet. The growth being removed is between 1.1 to 2.0 cm in size. The process is safe, typically involves local anesthesia, and is performed by a healthcare professional.

68 services59 patients

Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm 11442

This procedure involves the removal of a noncancerous skin growth on your face, ears, eyelids, nose, lips, or mouth that measures between 1.1-2.0 cm. It's a safe process to enhance your comfort and appearance.

59 services53 patients

Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm 11622

This procedure involves the careful removal of a cancerous skin growth measuring between 1.1 to 2.0 cm, located on the scalp, neck, hands, or feet. The goal is to eliminate the cancer and prevent its spread. This is done under local anesthesia to minimize discomfort.

49 services38 patients

Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm 11401

This procedure involves the removal of a noncancerous skin growth on your body, arms, or legs. The growth is between 0.6-1.0 cm in size. It's typically a simple process where the growth is cut away and the area is then stitched up for healing.

47 services39 patients

Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm 11641

This procedure involves the careful removal of a small cancerous growth on the face, ears, eyelids, nose, lips, or mouth. It's a precise operation performed by a specialist to ensure complete removal of the cancer while preserving healthy tissue.

41 services34 patients

Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm 11602

This procedure involves the surgical removal of a cancerous skin growth on the body, arms, or legs. The growth is between 1.1 and 2.0 cm in size. The goal is to eliminate cancer cells and prevent them from spreading to other parts of the body.

36 services28 patients

Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm 11441

This procedure involves the removal of a noncancerous skin growth on areas of the face such as the nose, lips, mouth, ears, or eyelids. The growth size is between 0.6-1.0 cm. The goal is to improve comfort, function, or appearance.

28 services27 patients

Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm 11403

This is a procedure where a noncancerous skin growth, sized 2.1-3.0 cm, on the body, arms, or legs is removed. It's typically done under local anesthesia. The process involves cutting out the growth and stitching the skin back together. The aim is to eliminate discomfort and prevent potential health issues.

27 services23 patients

Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm 11603

This procedure involves the removal of a cancerous skin growth, between 2.1 and 3.0 cm, from the body, arms, or legs. The area is numbed, then the growth is carefully cut out. The goal is to eliminate all cancer cells while minimizing scarring.

21 services17 patients

Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm 11623

This procedure involves removing a cancerous growth on the scalp, neck, hands, or feet that measures between 2.1 and 3.0 cm. The process includes numbing the area, excising the growth, and then stitching the wound for healing. The aim is to eliminate cancer cells and prevent spread.

12 services11 patients

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 Sullivan Surgicenter,llc's NPI number?

The NPI number for Sullivan Surgicenter,llc is 1700854072. It was assigned to this organization in the NPPES registry on March 10, 2006.

Where is Sullivan Surgicenter,llc located?

Sullivan Surgicenter,llc is located at 320 N Section St, Sullivan, IN 47882. The listed phone number is (812) 268-9000.

What is Sullivan Surgicenter,llc's specialty?

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

Does Sullivan Surgicenter,llc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D1030552) is associated with this NPI, valid through September 8, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Sullivan Surgicenter,llc accept?

Health plans from CareSource list Sullivan Surgicenter,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 Sullivan Surgicenter,llc was last updated on December 6, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.