Healthcare Provider Details

I. General information

NPI: 1801569348
Provider Name (Legal Business Name): CPSI SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2021
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2060 LANDER RD
MAYFIELD HTS OH
44124-4100
US

IV. Provider business mailing address

2060 LANDER RD
MAYFIELD HTS OH
44124-4100
US

V. Phone/Fax

Practice location:
  • Phone: 133-020-4758
  • Fax: 440-461-1440
Mailing address:
  • Phone: 133-020-4758
  • Fax: 440-461-1440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: JASON E LEEDY
Title or Position: OWNER
Credential:
Phone: 440-461-6100