RENAISSANCE SURGERY CENTER, LLC
NPI 1780157990
Clinic/Center - Ambulatory Surgical in Bristol, TN

NPI Status: Active since January 10, 2019

Contact Information

320 BRISTOL WEST BLVD STE 1A
BRISTOL, TN
ZIP 37620
Phone: (423) 844-1399

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • CLIA Number: 44D2163339
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 03-11-2027

About RENAISSANCE SURGERY CENTER, LLC

This page provides the complete NPI Profile along with additional information for Renaissance Surgery Center, Llc, a provider established in Bristol, Tennessee operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1780157990 assigned on January 2019. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Randall Sermons (Owner)

NPI
1780157990
Provider Name
RENAISSANCE SURGERY CENTER, LLC
Entity Type
Organization
Location Address
320 BRISTOL WEST BLVD STE 1A BRISTOL, TN 37620
Location Phone
(423) 844-1399
Mailing Address
PO BOX 9 ATTN CREDENTIALING KINGSPORT, TN 37662
Mailing Phone
(423) 857-2066
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-10-2019
Last Update Date
03-16-2022
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
  • BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
  • UHC Bronze Copay Focus (Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Copay Focus + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Bronze Essential (No Referrals) - EPO
  • UHC Bronze Standard (No Referrals) - EPO
  • UHC Gold Advantage (Virtual Urgent Care, No Referrals) - EPO
  • UHC Gold Advantage + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Gold Copay Focus (Virtual Urgent Care, No Referrals) - EPO
  • UHC Gold Standard (No Referrals) - EPO
  • UHC Silver Advantage (Virtual Urgent Care, No Referrals) - EPO
  • UHC Silver Advantage + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Silver Copay Focus (Virtual Urgent Care, No Referrals) - EPO
  • UHC Silver Standard (No Referrals) - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

RANDALL SERMONS

Authorized Official Title
OWNER
Authorized Official Phone
(423) 857-2028

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Creation of sling around urethra in female to control leakage

This procedure involves creating a supportive loop around a tube in your lower body that carries liquid waste. This helps manage any unwanted leakage, providing you with better control and comfort.

This service was performed 17 times for 17 patients

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

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.

This service was performed 88 times for 51 patients

Incision of tendon covering of finger

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.

This service was performed 16 times for 13 patients

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

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.

This service was performed 216 times for 124 patients

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

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.

This service was performed 231 times for 75 patients

Injection of substance into lower spine canal using imaging guidance

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.

This service was performed 43 times for 28 patients

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

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.

This service was performed 36 times for 19 patients

Plastic repair of vagina and tissue separating vagina, rectum, and bladder

This procedure involves the surgical restoration of the body's lower passage and the tissue that separates it from the waste and urine disposal systems. It's done to improve comfort and function due to conditions like injury or aging.

This service was performed 14 times for 14 patients

Release and/or relocation of hand nerve

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.

This service was performed 41 times for 37 patients

Repair of bladder hernia into vaginal wall

This procedure involves fixing a bulge in the bladder that has extended into the wall of the lower body passage. This bulge may cause discomfort or problems with normal body functions. The process realigns the bladder to its correct position, providing relief.

This service was performed 35 times for 35 patients

Repair of herniated rectum into vaginal wall

This procedure involves correcting a physical condition where part of the rectum bulges into the vaginal area. It's done by repositioning the rectum and strengthening the tissue between the two areas to prevent recurrence.

This service was performed 12 times for 12 patients

Repair of pelvic ligaments through vagina

This procedure involves mending the supportive tissues in your lower body region, accessed via the birth canal. It helps enhance stability and alleviate discomfort. The process is performed under anesthesia, ensuring a pain-free experience.

This service was performed 45 times for 45 patients

Replacement of knee joint, both sides of knee

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

This service was performed 52 times for 51 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
44D2163339
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
March 12, 2025
Certificate Expiration Date
March 11, 2027
Laboratory Director
DR. STEVEN HOLT
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Renaissance Surgery Center, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1780157990, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 70. The final step is to find the difference between that total and the next multiple of ten (70 - 70 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
0
Unchanged
Pos 5
1
Doubled → 2
Pos 6
5
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
9
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 1 → 2 7 → 14 → 5 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 6 + 0 + 2 + 5 + 1 + 4 + 9 + 1 + 8 + 24 = 70

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 70 is 70. The difference is the calculated check digit.

70 - 70 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1780157990.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Nurse Anesthetist, Certified Registered
320 BRISTOL WEST BLVD STE 1A
BRISTOL, TN 37620

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1780157990, enumerated as an "organization" on January 10, 2019.

The provider is located at 320 BRISTOL WEST BLVD STE 1A BRISTOL, TN 37620 and the phone number is (423) 844-1399.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: BlueCross BlueShield of Tennessee and. Please consult your insurance carrier or call the provider to verify.