MEDICARE: ENDOSCOPY CENTER OF ST THOMAS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	0000000017	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	490001323	OTHER	TN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225039761
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENDOSCOPY CENTER OF ST THOMAS LLC

Provider Business Mailing Address
First Line	:	1A BURTON HILLS BLVD STE 300
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-6153
Country	:	US
Telephone Number	:	615-263-4011
Fax Number	:	615-234-1720

Provider Business Practice Location Address
First Line	:	4230 HARDING PIKE STE 400
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-4900
Country	:	US
Telephone Number	:	615-250-4108
Fax Number	:	615-297-9825

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JEFFREY SNODGRASS
Credential	:
Telephone Number	:	615-665-1283

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	09/23/2025

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Directions to “ENDOSCOPY CENTER OF ST THOMAS LLC ” Practice Location

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