Individual provider Active NPI

Andrew Shane Kuhlman, PA-C

  • Surgical Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1003172560
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5114 Issued in AZ
Practice address
1635 E Myrtle Ave
Ste 400
Phoenix, AZ 85020-5556
Phone
(602) 944-2900
Fax
(602) 944-0064
NPI assigned
Apr 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 5114 AZ Primary

Addresses

Primary practice location

1635 E Myrtle Ave
Ste 400
Phoenix, AZ 85020-5556

Mailing address

1635 E Myrtle Ave
Suite 400
Phoenix, AZ 85020-5556
Phone (602) 944-2900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333929600000",
    "number": "1003172560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 E MYRTLE AVE",
            "address_2": "SUITE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205556",
            "telephone_number": "602-944-2900",
            "fax_number": "602-944-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 E MYRTLE AVE",
            "address_2": "STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205556",
            "telephone_number": "602-944-2900",
            "fax_number": "602-944-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUHLMAN",
        "first_name": "ANDREW",
        "middle_name": "SHANE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-09",
        "last_updated": "2012-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "5114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.