LAKE RIDGE SURGERY CENTER – NPI #1972850808
Clinic/Center

LAKE RIDGE SURGERY CENTER is an AHC clinic located in WOODBRIDGE, VA. NPPES has assigned the NPI number 1972850808 to LAKE RIDGE SURGERY CENTER on August 09, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “LAKE RIDGE SURGERY CENTER” is a dba name, the actual legal business name for this organization is LAKE RIDGE AMBULATORY SURGERY CENTER, LLC. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 12 years ago on Dec 27, 2013. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LAKE RIDGE SURGERY CENTER below.

NPI Profile for
LAKE RIDGE AMBULATORY SURGERY CENTER, LLC

NPI Number
1972850808
Enumeration Date

(about 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LAKE RIDGE AMBULATORY SURGERY CENTER, LLC
Doing Business As (dba): LAKE RIDGE SURGERY CENTER
Primary location
12825 MINNIEVILLE ROAD
SUITE 204
WOODBRIDGE, VA 22192
Phone: (703) 357-9568 Fax: (703) 357-9575
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JANET SMITH
ADMINISTRATOR
Phone: (703) 357-9568
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.