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SURGERY CLINIC, LLC - JACKSONVILLE
NPI 1780068460
Surgery in Jacksonville, AL

Active since July 13, 2015
1622 CHURCH AVE SE, JACKSONVILLE, AL 36265(256) 547-6331(256) 547-1711 Get Directions Write a Review

NPPES record last updated: February 10, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Surgery Clinic, Llc - Jacksonville NPPES

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

SURGERY CLINIC, LLC - JACKSONVILLE (NPI 1780068460) is a healthcare organization registered as a surgery in Jacksonville, Alabama and active in the NPI registry since July 2015. The organization lists Dianette Keener, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1780068460
Entity TypeOrganization
Primary Taxonomy208600000X
Legal Business NameSURGERY CLINIC, LLC
Location Address1622 CHURCH AVE SEJacksonville, AL 36265-3200
Mailing Address419 S 5th StGadsden, AL 35901-5101 · (256) 547-6331 · Fax (256) 547-1711
Phone(256) 547-6331
Fax(256) 547-1711
Organization SubpartYes
Authorized OfficialDianette KeenerBilling Manager · (256) 547-6331
Enumeration DateJuly 13, 2015
Last NPPES UpdateFebruary 10, 2021
NPPES CertifiedFebruary 10, 2021
✔ NPI 1780068460 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
1622 CHURCH AVE SE, Jacksonville, AL 36265
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Other Names 1

Doing Business AsSurgery Clinic, Llc - Jacksonville

Other Identifiers 1

Medicaid528202650AL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

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

OLIVIA SHEELY
Physical Therapist
1622 CHURCH AVE SE
JACKSONVILLE, AL 36265
Calhoun County (256) 365-2792
DERWIN BARNARD CANTRELL PT, DPT
Physical Therapist
1622 CHURCH AVE SE
JACKSONVILLE, AL 36265
Calhoun County (256) 365-2792
ASHTON CLEMMONS PTA
Physical Therapy Assistant
1622 CHURCH AVE SE
JACKSONVILLE, AL 36265
Calhoun County (256) 365-2792

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 Surgery Clinic, LLC's NPI number?

The NPI number for Surgery Clinic, LLC is 1780068460. It was assigned to this organization in the NPPES registry on July 13, 2015. The provider is doing business as Surgery Clinic, LLC - Jacksonville.

Where is Surgery Clinic, LLC located?

Surgery Clinic, LLC is located at 1622 Church Ave SE, Jacksonville, AL 36265. The listed phone number is (256) 547-6331.

What is Surgery Clinic, LLC's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

When was this NPI record last updated?

The NPPES record for Surgery Clinic, LLC was last updated on February 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.