SURGERY CLINIC, LLC – Surgery Physician, NPI 1205893732

SURGERY CLINIC, LLC is a healthcare provider. based in Gadsden, Alabama. specializing in Surgery Physician. The NPI Number for SURGERY CLINIC, LLC is 1205893732

Main info

Organization
Name
SURGERY CLINIC, LLC
NPI
1205893732
Phone
(256) 547-6331
Address
419 S 5TH ST
Authorized Official
DIANETTE KEENER BILLING MANAGER
Enumeration Date
27 April 2006
Last Update Date
17 August 2011
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:20State licenses:0Digital endpointsOther names

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Provider Addresses for SURGERY CLINIC, LLC

  • 419, South 5th Street, Gadsden, Etowah County, Alabama, 35901, United States

    GADSDEN, AL 359015101

    Phone: (256) 547-6331

    Fax: (256) 547-1711

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-03-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20110303000651OClinic/Group PracticeALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35901)

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Reviews

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Frequently asked questions

Can I cross-check SURGERY CLINIC, LLC using NPI 1205893732?
NPI 1205893732 belongs to SURGERY CLINIC, LLC; compare other details if you need extra assurance.
Is SURGERY CLINIC, LLC shown as active in public data?
Registry records indicate SURGERY CLINIC, LLC maintains an active NPI.
How would a patient describe SURGERY CLINIC, LLC's focus?
For SURGERY CLINIC, LLC, the primary taxonomy reads as Surgery Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with SURGERY CLINIC, LLC?
Directory geography for SURGERY CLINIC, LLC centers on Gadsden, Alabama.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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