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VAN DYCK ASC, LLC
NPI 1760414056
Clinic/Center - Ambulatory Surgical in Paris, TN

Active since July 07, 2006CLIA 44D2003462 · Waiver
1024 KELLEY DR, PARIS, TN 38242(731) 642-5003(731) 642-8756 Get Directions Write a Review

NPPES record last updated: February 17, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 17, 2022, May 10, 2017 (2 updates tracked since 2017).

About Van Dyck Asc, Llc NPPES

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

VAN DYCK ASC, LLC (NPI 1760414056) is a healthcare organization registered as an ambulatory surgical in Paris, Tennessee and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through February 9, 2028 and lists James C Loden, Owner/medical Director, as its authorized official.

NPPES Registry Identity

NPI1760414056
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameVAN DYCK ASC, LLC
Location Address1024 KELLEY DRParis, TN 38242-4500
Mailing Address1024 Kelley DrParis, TN 38242-4500 · (731) 642-5003 · Fax (731) 642-8756
Phone(731) 642-5003
Fax(731) 642-8756
Organization SubpartNo
Authorized OfficialJames C LodenOwner/medical Director · (731) 642-5003
Enumeration DateJuly 7, 2006
Last NPPES UpdateFebruary 17, 20222 updates tracked since enumeration
NPPES CertifiedFebruary 17, 2022
✔ NPI 1760414056 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
Licenses✔ Licensed in TN · TN23✔ Licensed in TN · 0000000023
1024 KELLEY DR, Paris, TN 38242
Open in Google Maps ↗

Other Identifiers 1

Medicaid3288423TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, Cigna Healthcare, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Van Dyck Asc, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Van Dyck ASC, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Nicholas Hackett, MD
Ophthalmology
NPI 1649663311
1725 MEDICAL CENTER PKWY STE 120
Murfreesboro, TN 37129
(629) 219-4040
✔ PECOS✔ Accepts Medicare110 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 44D2003462

Van Dyck ASC, LLC · Paris, TN
Active · expires Feb 9, 2028
CLIA Number44D2003462
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateFebruary 10, 2026
Certificate Expiration DateFebruary 9, 2028
Laboratory DirectorJames C. Loden
Laboratory Phone(731) 642-5003
Laboratory LocationVan Dyck ASC, LLC1024 Kelley Drive, Paris, TN 38242
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 4

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 cataract with insertion of prosthetic lens 66984
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.
803 services444 patients
Removal of recurring cataract in lens capsule using a laser 66821
This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.
480 services322 patients
Dilation of fluid outflow drainage within eye 66174
Dilation to improve eye fluid flow is a process where eye drops are used to widen or dilate your pupils. This allows more fluid to flow out of the eye, reducing pressure and helping to prevent or treat conditions like glaucoma.
28 services19 patients
Complex removal of cataract with insertion of prosthetic lens 66982
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.
17 services14 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 Van Dyck ASC, LLC's NPI number?

The NPI number for Van Dyck ASC, LLC is 1760414056. It was assigned to this organization in the NPPES registry on July 7, 2006.

Where is Van Dyck ASC, LLC located?

Van Dyck ASC, LLC is located at 1024 Kelley Dr, Paris, TN 38242. The listed phone number is (731) 642-5003.

What is Van Dyck ASC, LLC's specialty?

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

Is Van Dyck ASC, LLC enrolled in Medicare?

Yes. Van Dyck ASC, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Van Dyck ASC, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Ophthalmology) reassigns their Medicare billing to Van Dyck ASC, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Van Dyck ASC, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D2003462) is associated with this NPI, valid through February 9, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Van Dyck ASC, LLC accept?

Health plans from BlueCross BlueShield of Tennessee, Cigna Healthcare and UnitedHealthcare list Van Dyck ASC, 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 Van Dyck ASC, LLC was last updated on February 17, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.