Healthcare Provider Details
I. General information
NPI: 1487742680
Provider Name (Legal Business Name): NOVAMED SURGERY CENTER OF CLEVELAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/11/2006
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
137 25TH ST NE
CLEVELAND TN
37311-3944
US
IV. Provider business mailing address
137 25TH STREET NE
CLEVELAND TN
37311-0001
US
V. Phone/Fax
- Phone: 423-472-7874
- Fax: 423-472-2881
- Phone: 423-472-7874
- Fax: 423-472-2881
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | 0000000002 |
| License Number State | TN |
VIII. Authorized Official
Name:
MARIETHA
SILVERS, RN, BS, CASC
Title or Position: ADMINISTRATOR
Credential:
Phone: 423-472-7874